Asociación entre obesidad y diagnóstico de cáncer de próstata en adultos mayores: análisis secundario de la encuesta SABE / Association between Obesity and Prostate Cancer Diagnosis in Elderly Men: Secondary Analysis of the SABE survey

Introducción El síndrome metabólico es una condición muy prevalente en nuestra sociedad, y durante las últimas dos décadas la prevalencia ha aumentado significativamente convirtiéndose en un problema con una carga en salud importante. El cáncer de próstata por su parte es la primera causa de cáncer en hombres en el mundo. Numerosos estudios han sugerido una asociación entre la presencia de síndrome metabólico y el diagnóstico de cáncer de próstata. La información acerca de la asociación Del cáncer de próstata y obesidad es controversial. Nuestro objetivo es determinar si existe una relación entre la presencia de obesidad y el diagnóstico de cáncer de próstata en adultos mayores de la ciudad de Bogotá. Objetivos y Métodos Se analizaron los datos del estudio Salud, Bienestar y Envejecimiento (SABE) Bogotá 2012. Se utilizó como variable dependiente el autorreporte de examen de próstata en los 2 últimos años y se evaluó con respecto a variables antropométricas así como factores sociodemográficos por medio de un análisis multivariado. Resultados La prevalencia de cáncer de próstata fue de 3,15%. El 31.9% de los hombres tienen un IMC mayor de 30. Se encontró una asociación significativa entre el IMC y el diagnóstico de cáncer de próstata (p = 0.005), Enfermedad coronaria y cáncer de próstata (p = 0.03) y nivel de escolaridad y diagnóstico de Cáncer de próstata (p = 0.012). Conclusión Nuestro estudio demuestra que existe una asociación significativa entre estas dos entidades en una población bogotana de adultos mayores. Es necesario realizar más estudios que aporten mayor información acerca de esta asociación.

Introduction Metabolic syndrome is a very prevalent condition in our society, and during the last two decades the prevalence has increased remarkably becoming a problem with a significant health burden. Prostate cancer, on the other side, is the leading cause of cancer in men around the world. Several studies have suggested an association between the presence of metabolic syndrome and the diagnosis of prostate cancer. The information about the association of prostate cancer and obesity is controversial. Our objective is to determine if there is a relationship between the presence of obesity and the diagnosis of prostate cancer in older adults in the city of Bogotá. Objective and Methods Data from the Health, Wellbeing and Aging study (SABE) Bogotá 2012 were analyzed. Self-report of prostate exam in the last 2 years was used as a dependent variable and was evaluated with respect to anthropometric variables as well as sociodemographic factors through a multivariate analysis. Results The prevalence of prostate cancer was 3.15%. 31.9% of men have a BMI greater than 30. A significant association was found between BMI and the diagnosis of prostate cancer (p = 0.005), coronary disease and prostate cancer (p = 0.03) and level of education and diagnosis of prostate cancer (p = 0.012). Conclusion Our study shows that there is a significant association between these two entities in a Bogota population of older adults. It is necessary to carry out more studies that provide more information about this association.

Iluminando las decisiones e intervenciones públicas para la población adulta mayor: estudio SABE Bogotá / Enlightening decisions and public interventions for the older adult population: SABE Bogotá study

ResumenObjetivo: Destacar los resultados de mayor impacto para la población adulta mayor en Bogotá, de ma-nera que sirvan como referencias para priorizar las decisiones y las medidas públicas en su beneficio. Materiales y métodos: Estudio de cohorte transversal, con un muestreo probabilístico por conglome-rados, polietápico, con un nivel de confiabilidad del 95% y un tamaño de 2000 personas entre 60 y 100 años. Se realizó un análisis descriptivo de todas las variables, calculando distribuciones de frecuencias simples y posteriormente se hizo un análisis de dependencia y asociación con Chi cuadrado, T-test y regresiones logísticas multivariadas según correspondiera para cada caso. Adicionalmente se utilizan pruebas de Spearman Rho para analizar correlaciones. Se analizaron los temas principales: fragilidad, sarcopenia, nutrición, hipertensión arterial (HTA), depresión, violencia, discapacidad, vivir solo y pobreza. Resultados: Cerca del 40% de la población tenía desnutrición o estaba en riesgo de desnutri-ción, más del 60% era prefrágil o frágil y más del 11% tenía sarcopenia. La HTA se presentó en el 58% de los ancianos; la depresión estaba presente en uno de cada cuatro; 42% había sido víctima de agre-sión en el último año y el 43% desplazado por violencia en el transcurso de su vida. Más de la mitad tenía una discapacidad, 12,6% vivía solo y el 7,8% estaba en pobreza extrema. Conclusiones: Cada una de las temáticas desarrolladas aporta individualmente en la selección de los mejores derroteros de la política pública para el Distrito Capital, pues sólo su integración, bajo la tutela de los gestores de la misma y la participación ciudadana desde los diferentes escenarios y participantes, logrará el mejor impacto en la aplicabilidad de este trabajo de investigación

AbstractObjective:thisworkhighlightstheresultswiththegreatestimpactfortheolderadultpopula-tioninBogotá.Theseresultsshouldserveasreferencestoprioritizedecisionsanddeveloppublichealthinterventionstobenefittheseolderadults.Materials and methods:W euseddatafromacross-sectionalstudy,withamultistageprobabilisticsamplingbyconglomerates.Aofreliabilitylevelof95%wasestablishedandthesamplesizewas2000individualsbetweentheagesof60and100years.Adescriptiveanalysisofallthevariableswasconducted,esti-matingfrequenciesandsubsequentlyanalyzingdependencyandassociationwithChisquare,T-testsandmultivariatelogisticregressionsasappropriateforeachcase.Additionally,Spear-manRhotestswereusedtoanalyzecorrelations.Themaintopicsanalyzedwere:frailty,sarcopenia,nutrition,hypertension(HTN),depression,violence,disability,livingaloneandpoverty.Results:about40%ofthepopulationwasmalnourishedoratriskofmalnutrition,morethan60%waspre-frailorfrailandmorethan11%hadsarcopenia.HTNwasreportedin58%ofolderadults,42%hadbeenvictimsofviolenceinthelastyearand43%hadbeendisplacedbyviolenceduringtheirlife.Morethanhalfhaddisability,12,6%livedaloneand7,8%hadextremepoverty.Conclusions: theseresultsshouldhelpidentifythemostpressingissuesfacedbyolderadultsinthecapitalofColombiaandshoulddrivethedevelopmentofpublichealthinterventionsforthecity.Onlyintegrationoftheseresultswithactiveparticipa-tionofpolicymakersandthecommunitywillresultinimprovementsforolderadultsandthepopulationatlarge

Hypoxia decreases creatine uptake in cardiomyocytes, while creatine supplementation enhances HIF activation.

Creatine (Cr), phosphocreatine (PCr), and creatine kinases (CK) comprise an energy shuttle linking ATP production in mitochondria with cellular consumption sites. Myocytes cannot synthesize Cr: these cells depend on uptake across the cell membrane by a specialized creatine transporter (CrT) to maintain intracellular Cr levels. Hypoxia interferes with energy metabolism, including the activity of the creatine energy shuttle, and therefore affects intracellular ATP and PCr levels. Here, we report that exposing cultured cardiomyocytes to low oxygen levels rapidly diminishes Cr transport by decreasing Vmax and Km Pharmacological activation of AMP-activated kinase (AMPK) abrogated the reduction in Cr transport caused by hypoxia. Cr supplementation increases ATP and PCr content in cardiomyocytes subjected to hypoxia, while also significantly augmenting the cellular adaptive response to hypoxia mediated by HIF-1 activation. Our results indicate that: (1) hypoxia reduces Cr transport in cardiomyocytes in culture, (2) the cytoprotective effects of Cr supplementation are related to enhanced adaptive physiological responses to hypoxia mediated by HIF-1, and (3) Cr supplementation increases the cellular ATP and PCr content in RNCMs exposed to hypoxia.

Zinc deficiency primes the lung for ventilator-induced injury.

Mechanical ventilation is necessary to support patients with acute lung injury, but also exacerbates injury through mechanical stress-activated signaling pathways. We show that stretch applied to cultured human cells, and to mouse lungs in vivo, induces robust expression of metallothionein, a potent antioxidant and cytoprotective molecule critical for cellular zinc homeostasis. Furthermore, genetic deficiency of murine metallothionein genes exacerbated lung injury caused by high tidal volume mechanical ventilation, identifying an adaptive role for these genes in limiting lung injury. Stretch induction of metallothionein required zinc and the zinc-binding transcription factor MTF1. We further show that mouse dietary zinc deficiency potentiates ventilator-induced lung injury, and that plasma zinc levels are significantly reduced in human patients who go on to develop acute respiratory distress syndrome (ARDS) compared with healthy and non-ARDS intensive care unit (ICU) controls, as well as with other ICU patients without ARDS. Taken together, our findings identify a potentially novel adaptive response of the lung to stretch and a critical role for zinc in defining the lung's tolerance for mechanical ventilation. These results demonstrate that failure of stretch-adaptive responses play an important role in exacerbating mechanical ventilator-induced lung injury, and identify zinc and metallothionein as targets for lung-protective interventions in patients requiring mechanical ventilation.

Assessment of factors associated with functional status in 60 years-old and older adults in Bogotá, Colombia.

INTRODUCTION: Functional impairment produces a wide range of negative effects such as difficulty in mobility, social isolation, decreased quality of life, disability and institutionalization. Thus, functional status measurement is a marker of social wellbeing. OBJECTIVE: To determine and characterize the socio-demographic factors and health conditions related to functional impairment in older adults in Bogotá, Colombia. MATERIALS AND METHODS: Data was collected from the SABE Bogotá Study. Functional status was assessed using the Barthel and Lawton scales. Independent variables included socio-demographic factors, comorbidities, anthropometric measurements and physical activity (by tertiles). Bivariate analyzes were performed, and multivariate results were obtained using linear regression models. RESULTS: There were 2,000 participants aged 60 years and older, with a mean age of 71.2 ± 8 years. Younger age (standardized beta = -0.15, p<0.01), fewer medications (beta= -0.13, p<0.01), higher MMSE score (beta = 0.3, p< 0.01), higher level of physical activity (middle beta tertile = 0.18, p<0.01, and higher beta tertile= 0.18, p<0.01vs lower tertile) and better performance in the handgrip test (beta= 0.10, p<0.01) were associated with better function in daily life instrumental activities. Similarly, higher MMSE score (beta= 0.3, p<0.01) and better performance in the handgrip test (beta= 0.07, p= 0.02) were associated with better function in daily life basic activities. CONCLUSIONS: We found several factors related with functional impairment, which are likely to be modified to reduce dependence in this population.

Evaluación de factores asociados al estado funcional en ancianos de 60 años o más en Bogotá, Colombia / Assessment of factors associated with functional status in 60 years-old and older adults in Bogotá, Colombia

Resumen Introducción. La declinación funcional produce un amplio espectro de efectos negativos, como dificultad para la movilidad, aislamiento social, deterioro de la calidad de vida, discapacidad e internación en instituciones especializadas, lo cual convierte la medición de la funcionalidad en un marcador importante del bienestar. Objetivo. Caracterizar y determinar los factores asociados con el deterioro funcional del anciano en Bogotá. Materiales y métodos. Se utilizaron los datos del Estudio SABE-Bogotá. El estado funcional de los participantes se evaluó mediante las escalas de Barthel y Lawton. Se usaron como variables independientes los factores sociodemográficos, las enfermedades concomitantes, las medidas antropométricas y los terciles de actividad física, y se obtuvieron análisis bivariados y multivariados con regresiones lineales. Resultados. Se entrevistaron 2.000 personas de 60 o más años, con una edad promedio de 71,2 ± 8 años. Una mayor funcionalidad en actividades instrumentales se asoció con una menor edad (valor beta estandarizado: -0,15; p<0,01), un menor número de medicamentos (valor beta: -0,13; p<0,01), un mayor puntaje en el Mini-mental State Examination, MMSE) (valor beta: 0,3; p<0,01), un mayor nivel de actividad física (tercil medio: 0,18; p<0,01 y tercil alto de beta: 0,18; p<0,01 Vs. tercil bajo) y una mayor fuerza de prensión (valor beta: 0,10; p<0,01),en tanto que una mayor funcionalidad en las actividades básicas se asoció con un mayor puntaje en el MMSE (valor beta: 0,3; p<0,01) y una mayor fuerza de prensión (valor beta: 0,07; p=0,020). Conclusiones. En este estudio se determinaron múltiples factores relacionados con la alteración funcional que pueden modificarse para disminuir la dependencia en este grupo poblacional.

Abstract Introduction: Functional impairment produces a wide range of negative effects such as difficulty in mobility, social isolation, decreased quality of life, disability and institutionalization. Thus, functional status measurement is a marker of social wellbeing. Objective: To determine and characterize the socio-demographic factors and health conditions related to functional impairment in older adults in Bogotá, Colombia. Materials and methods: Data was collected from the SABE Bogotá Study. Functional status was assessed using the Barthel and Lawton scales. Independent variables included socio-demographic factors, comorbidities, anthropometric measurements and physical activity (by tertiles). Bivariate analyzes were performed, and multivariate results were obtained using linear regression models. Results: There were 2,000 participants aged 60 years and older, with a mean age of 71.2 ± 8 years. Younger age (standardized beta = -0.15, p<0.01), fewer medications (beta= -0.13, p<0.01), higher MMSE score (beta = 0.3, p< 0.01), higher level of physical activity (middle beta tertile = 0.18, p<0.01, and higher beta tertile= 0.18, p<0.01vs lower tertile) and better performance in the handgrip test (beta=0.10, p<0.01) were associated with better function in daily life instrumental activities. Similarly, higher MMSE score (beta= 0.3, p<0.01) and better performance in the handgrip test (beta= 0.07, p= 0.02) were associated with better function in daily life basic activities. Conclusions: We found several factors related with functional impairment, which are likely to be modified to reduce dependence in this population.

Self-reported vaccination in the elderly: SABE Bogota study, Colombia.

OBJECTIVES: To determine the frequency of vaccination in older adults within the city of Bogotá and to estimate the association with sociodemographic and health factors. METHODS: This is a secondary data analysis from the SABE-Bogotá Study, a cross-sectional population-based study that included a total of 2,000 persons aged 60 years. Weighted percentages for self-reported vaccination [influenza, pneumococcal, tetanus] were determined. The association between vaccination and covariates was evaluate by logistic regression models. RESULTS: A total of 73.0% of respondents received influenza, 57.8% pneumococcal and 47.6% tetanus vaccine. Factors independently associated with vaccination included: 1- age (65-74 years had higher odds of receiving vaccinations, compared to 60-64 years); 2- socioeconomic status (SES) (higher SES had lower odds of having influenza and pneumococcal vaccines, compared to those with lower SES); 3- health insurance (those with contributive or subsidized health insurance had higher odds (between 3 and 5 times higher) of having vaccinations, compared to those with no insurance); 4- older adults with better functional status (greater Lawton scores) had increased odds for all vaccinations; 5- older adults with higher comorbidity had increased odds for influenza and pneumococcal vaccinations. CONCLUSION: Vaccination campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination or vulnerable to reach it such as the disabled elder.

OBJETIVOS: Determinar la frecuencia de vacunación en la población adulta mayor de la ciudad de Bogotá, y estimar la asociación con factores sociodemográficos y de salud. MÉTODOS: Este es un análisis secundario de datos del estudio SABE-Bogotá, un estudio poblacional transversal que incluyó un total de 2,000 personas mayores de 60 años. Se obtuvieron porcentajes ponderados del auto-reporte de vacunación (influenza, neumococo, tétano). La asociación entre la vacunación y otras variables se evaluó mediante modelos de regresión logística. RESULTADOS: el 73.0% se vacunó contra la Influenza, 57.8% contra el Neumococo y el 47.6% recibió la antitetánica. Los factores que estaba independientemente asociados con la vacunación incluyen: 1-edad (65-74 tenían probabilidad aumentada comparada con 60-64 años); 2- nivel socioeconómico (NSE) (mayor NSE tenían menos probabilidades de tener vacunas contra la influenza y neumococo, en comparación con aquellos con menor NSE); 3- seguro de salud (con seguro contributivo o subsidiado tenían probabilidades más altas, (entre 3 y 5 veces mayor) de tener vacunación contra la influenza, neumococo y tétanos, en comparación con aquellos que no tienen seguro); 4- aquellos con estado funcional mejor (puntaje mayor Lawton) tenían probabilidades mayores para todas las vacunas; 5- aquellos con morbilidad aumentada tenían probabilidades mayores para tener vacunas de influenza y neumococo. CONCLUSIÓN: Las campañas de vacunación se deben fortalecer para incrementan la cobertura, especialmente en el grupo más reacio a la vacunación o vulnerable para alcanzarla tales como los adultos mayores con discapacidad.

Self-reported vaccination in the elderly: SABE Bogotá study, Colombia / El auto reporte de vacunación en los adultos mayores: Estudio SABE Bogotá, Colombia

Objectives: To determine the frequency of vaccination in older adults within the city of Bogotá and to estimate the association with sociodemographic and health factors. Methods: This is a secondary data analysis from the SABE-Bogotá Study, a cross-sectional population-based study that included a total of 2,000 persons aged 60 years. Weighted percentages for self-reported vaccination [influenza, pneumococcal, tetanus] were determined. The association between vaccination and covariates was evaluate by logistic regression models. Results: A total of 73.0% of respondents received influenza, 57.8% pneumococcal and 47.6% tetanus vaccine. Factors independently associated with vaccination included: 1- age (65-74 years had higher odds of receiving vaccinations, compared to 60-64 years; 2socioeconomic status (SES) (higher SES had lower odds of having influenza and pneumococcal vaccines, compared to those with lower SES); 3- health insurance (those with contributive or subsidized health insurance had higher odds (between 3 and 5 times higher) of having vaccinations, compared to those with no insurance); 4- older adults with better functional status (greater Lawton scores) had increased odds for all vaccinations; 5- older adults with higher comorbidity had increased odds for influenza and pneumococcal vaccinations. Conclusion: Vaccination campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination or vulnerable to reach it such as the disable elder.

Objetivos: determinar la frecuencia de vacunación en la población adulta mayor de la ciudad de Bogotá, y estimar la asociación con factores sociodemográficos y de salud. Métodos: Este es un análisis secundario de datos del estudio SABE-Bogotá, un estudio poblacional transversal que incluyó un total de 2,000 personas mayores de 60 años. Se obtuvieron porcentajes ponderados del auto-reporte de vacunación (influenza, neumococo, tétano). La asociación entre la vacunación y otras variables se evaluó mediante modelos de regresión logística. Resultados: el 73.0% se vacunó contra la Influenza, 57.8% contra el Neumococo y el 47.6% recibió la antitetánica. Los factores que estaba independientemente asociados con la vacunación incluyen: 1-edad (6574 tenían probabilidad aumentada comparada con 60-64 años); 2- nivel socioeconómico (NSE) (mayor NSE tenían menos probabilidades de tener vacunas contra la influenza y neumococo, en comparación con aquellos con menor SES); 3- seguro de salud (con seguro contributivo o subsidiado tenían probabilidades más altas, (entre 3 y 5 veces mayor) de tener vacunación contra la influenza, neumococo y tétanos, en comparación con aquellos que no tienen seguro); 4- aquellos con estado funcional mejor (puntaje mayor Lawton) tenían probabilidades mayores para todas las vacunas; 5- aquellos con morbilidad aumentada tenían probabilidades mayores para tener vacunas de influenza y neumococo. Conclusión: Las campañas de vacunación se deben fortalecer para incrementan la cobertura, especialmente en el grupo más reacio a la vacunación o vulnerable para alcanzarla tales como los adultos mayores con discapacidad.

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at p<0.05. Of the 2000 respondents, 98.3% were edentulous, 73.0% reported half or more missing teeth, 76.9% used dental prostheses and 23.7% had related eating problems. Older age, lower social class and lower education were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (p<0.05) and dental prosthesis did not improve EQ-VAS scores (p=0.22). Edentulism also showed a significant negative correlation with EQ-VAS scores (rho= -0.102, p<0.01). In summary, EQ-VAS is a useful tool for measuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

Increased yield of endothelial cells from peripheral blood for cell therapies and tissue engineering.

AIM: Peripheral blood-derived endothelial cells (pBD-ECs) are an attractive tool for cell therapies and tissue engineering, but have been limited by their low isolation yield. We increase pBD-EC yield via administration of the chemokine receptor type 4 antagonist AMD3100, as well as via a diluted whole blood incubation (DWBI). MATERIALS & METHODS: Porcine pBD-ECs were isolated using AMD3100 and DWBI and tested for EC markers, acetylated LDL uptake, growth kinetics, metabolic activity, flow-mediated nitric oxide production and seeded onto titanium tubes implanted into vessels of pigs. RESULTS: DWBI increased the yield of porcine pBD-ECs 6.6-fold, and AMD3100 increased the yield 4.5-fold. AMD3100-mobilized ECs were phenotypically indistinguishable from nonmobilized ECs. In porcine implants, the cells expressed endothelial nitric oxide synthase, reduced thrombin-antithrombin complex systemically and prevented thrombosis. CONCLUSION: Administration of AMD3100 and the DWBI method both increase pBD-EC yield.

Nutritional assessment and factors associated to malnutrition in older adults: a cross-sectional study in Bogotá, Colombia.

OBJECTIVE: To determine the nutritional status and factors associated to malnutrition in older adults. METHOD: Data come from the SABE Bogotá study (Health, Well-Being, and Aging), a cross-sectional survey conducted in Bogotá, Colombia, in 2012 in community-dwelling adults aged 60 years and older. Using the Mini Nutritional Assessment (MNA), we evaluated the nutritional status and factors associated to malnutrition in this population with regression models. RESULTS: From the 1,573 older adults interviewed, 4.58% were malnourished and 34.27% were at risk of malnourishment. Factors associated to malnourishment were older age (odds ratio [OR] =1.02, 95% confidence interval [CI] = [1.00, 1.04]), perceived poor health (OR = 1.46, 95% CI = [1.13, 1.88]), comorbidities (OR = 1.16, 95% CI = [1.04, 1.30]), and low calf circumference (OR = 2.63, 95% CI = [1.86, 3.72]). Having dentures, perception of being well-nourished, and higher functionality decreased the odds for malnourishment (p < .05). CONCLUSION: The MNA is useful to evaluate factors associated with malnutrition among older adults in Bogotá. Malnutrition is associated with perception of poor health, comorbidities, number of medications, and cognitive impairment.

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol-visual analog scale (EQ-VAS) / Edentulismo y prótesis dentales en el adulto mayor: impacto sobre la calidad de vida medido con euroqol – escala visual análoga (eq-vas)

El objetivo de este estudio fue medir el impacto del edentulismo y el uso de prótesis dentales en la calidad de vida de los adultos mayores en Bogotá, Colombia. El edentulismo es frecuente en los adultos mayores y afecta profundamente su calidad de vida. Actualmente existen pocos datos epidemiológicos disponibles sobre este tema en nuestro medio. Los datos fueron extraídos del estudio SABE-Bogotá, estudio transversal por conglomerados llevado a cabo en el 2012. Se uso el EQ-VAS (escala visual análoga) como instrumento de medición de la percepción de la calidad de vida. El estudio incluyó 2.000 individuos mayores de 60 años. Se usó el test de Sperman-Rho para analizar la correlación entre el EQ-VAS, el edentulismo y el uso de prótesis. Las pruebas de Chi-cuadrado, ANOVA y t-test se usaron para estudiar las diferencias en los puntajes del EQ-VAS entre los sujetos edéntulos y sanos. La significancia estadística se estableció en <0.05. De los 2000 encuestados, 98.3 por ciento fueron edéntulos, 73.0 por ciento reportaron perdida de mas de la mitad de sus dientes, 76.9 por ciento reportaron usar prótesis dentales y 23.7 por ciento problemas relacionados con la alimentación. La edad avanzada, el estrato social bajo y el bajo nivel educativo se relacionaron con mayor pérdida dental. Individuos con pocos dientes y prótesis dentales tuvieron puntajes bajos en el EQ-VAS (p=0.22). La presencia de edentulismo también mostró una correlación negativa con los puntajes del EQ-VAS (rho= -0.102, p<0.01). Se concluye que EQ-VAS es un instrumento de gran utilidad para la medición de calidad de vida en contextos relacionados a salud oral. El edentulismo afecta significativamente la calidad de vida en los adultos mayores y el uso de prótesis dentales no mejora la percepción de la calidad de vida.

The objective of this study was to measure the impact of edentulismand dental prostheses on quality of life (QOL) in older adults inBogotá, Colombia. Edentulism is a frequent condition in olderadults and has great impact on their QOL. No epidemiologicaldata are currently available on edentulism among older adults inColombia. Data were obtained from the SABE-Bogotá study, across-sectional study conducted in 2012, and used to analyze theEQ-VAS (Visual Analog Scale) from the EuroQol instrument tomeasure the perception of quality of life (QOL) in relation toedentulism. The study included 2,000 individuals over 60 yearsold. The Spearman-Rho correlation was used to analyze thecorrelation between EQ-VAS and edentulism. Chi-Square, ANOVAand t-test were used to study the differences in EQ-VAS scoresbetween edentulous and healthy subjects. Statistical significancewas set at p<0.05. Of the 2000 respondents, 98.3% wereedentulous, 73.0% reported half or more missing teeth, 76.9%used dental prostheses and 23.7% had related eating problems.Older age, lower social class and lower education were related toedentulism. Individuals with fewer teeth and dental prostheses hadlower EQ-VAS scores (p<0.05) and dental prosthesis did notimprove EQ-VAS scores (p=0.22). Edentulism also showed asignificant negative correlation with EQ-VAS scores (rho= -0.102,p<0.01). In summary, EQ-VAS is a useful tool for measuring theperception of QOL in dental health scenarios. Edentulismsignificantly affects QOL in older adults and the use of dentalprosthesis does not improve the perception of QOL.

[Hearing disorders in elderly people, associated factors and quality of life: SABE Study, Bogotá, Colombia]. / Problemas de la audición en el adulto mayor, factores asociados y calidad de vida: estudio SABE, Bogotá, Colombia.

INTRODUCTION: The aging of the population is a universal epidemiological phenomenon which is not unfamiliar to us and is accompanied by a marked increase of life expectancy. Age-dependent comorbidities, such as hearing disorders, are more prevalent and affect the quality of life in a noticeable manner. OBJECTIVE: To estimate the prevalence of hearing disorders, of the associated factors and their impact on the quality of life of older adults in Bogota. MATERIALS AND METHODS: Data was taken from the Bogotá SABE Study, which included 2,000 individuals aged =60 years in a probabilistic cross-sectional study sampled by clusters (with 81.9% coverage). We used the "hearing disorders" variable relating it to socio-demographic variables, as well as to the use of hearing aids, the self-perceived health, the comorbidities, the functionality, the cognition and the quality of life as measured with the Visual Analog Scale of the EuroQol Group (EQ-VAS). RESULTS: We found a prevalence of hearing disorders in 267 individuals (13.5%), of whom 15% used hearing aids. The frequency was higher in individuals aged =75 years (46.1%), in the low socioeconomic level (20.2%) and among illiterate people (19.3%, p<0.05). Regarding comorbidities, we found a higher prevalence in individuals suffering from depression (20.2%, p<0.001), and high blood pressure (15%, p<0.01). The quality of life was worse in individuals with hearing disorders, as measured with the EuroQol EQ-VAS (60.93 ± 1.38 vs. 71.75 ± 0.45, p< 0.0001), but it improved among those who used hearing aids as compared to those who did not use them (59.59 ± 1.52, p<0.01). CONCLUSIONS: Hearing disorders are relevant in elderly individuals and they affect their perceived quality of life in a noticeable manner. In addition, they are associated with other clinical, functional and cognitive problems. Nevertheless, the intervention with hearing aids reverses that perception.

Problemas de la audición en el adulto mayor, factores asociados y calidad de vida: estudio SABE, Bogotá, Colombia / Hearing disorders in elderly people, associated factors and quality of life: SABE Study, Bogotá, Colombia

Introducción. El envejecimiento de la población es un fenómeno epidemiológico universal que conlleva un acentuado aumento de la expectativa de vida y al cual no somos ajenos. Las enfermedades concomitantes dependientes de la edad, entre ellas los problemas auditivos, son cada día más prevalentes e inciden notoriamente en la calidad de vida. Objetivo. Estimar la prevalencia de los problemas de audición, así como de los factores asociados y su efecto en la calidad de vida de los adultos mayores en Bogotá. Materiales y métodos. Se analizaron los datos del estudio SABE, Bogotá, en el curso del cual se entrevistó a 2.000 personas de 60 años o más en una muestra transversal probabilística por conglomerados (cobertura de 81,9 %). Se utilizó la variable "problemas en la audición" y se relacionó con los factores sociodemográficos, el uso de dispositivos auriculares, la percepción de la propia salud, las enfermedades concomitantes, la funcionalidad, la cognición y la calidad de vida, medida esta con la escala visual analógica del grupo EuroQOL ( EuroQoL-Visual Analogue Scale , EQ-VAS). Resultados. Se encontró una prevalencia de problemas de audición en 267 personas (13,5 %), de las cuales el 15 % utilizaba audífonos; dicha prevalencia fue mayor en aquellas de 75 o más años (46,1 %), en el nivel socioeconómico bajo (20,2 %) y entre analfabetas (19,3 %, p<0,05). Se encontró mayor prevalencia en las personas con depresión (20,2 %, p<0,001) y con hipertensión arterial (15 %, p<0,01). En aquellas con problemas de audición se encontró peor calidad de vida medida por la EQ-VAS (60,93±1,38 Vs . 71,75±0,45, p<0,0001). Cuando las personas usaban los audífonos, su calidad de vida mejoraba en comparación con la de quienes no los utilizaban (59,59±1,52, p<0,01). Conclusiones. Los problemas auditivos son relevantes en los adultos mayores e inciden notoriamente en su percepción de la calidad de vida, asociándose con otras situaciones clínicas, funcionales y cognoscitivas; sin embargo, el uso de audífonos revierte esta percepción.

Introduction: The aging of the population is a universal epidemiological phenomenon which is not unfamiliar to us and is accompanied by a marked increase of life expectancy. Age-dependent comorbidities, such as hearing disorders, are more prevalent and affect the quality of life in a noticeable manner. Objective: To estimate the prevalence of hearing disorders, of the associated factors and their impact on the quality of life of older adults in Bogota. Materials and methods: Data was taken from the Bogotá SABE Study, which included 2,000 individuals aged =60 years in a probabilistic cross-sectional study sampled by clusters (with 81.9% coverage). We used the "hearing disorders" variable relating it to socio-demographic variables, as well as to the use of hearing aids, the self-perceived health, the comorbidities, the functionality, the cognition and the quality of life as measured with the Visual Analog Scale of the EuroQol Group (EQ-VAS). Results: We found a prevalence of hearing disorders in 267 individuals (13.5%), of whom 15% used hearing aids. The frequency was higher in individuals aged =75 years (46.1%), in the low socioeconomic level (20.2%) and among illiterate people (19.3%, p<0.05). Regarding comorbidities, we found a higher prevalence in individuals suffering from depression (20.2%, p<0.001), and high blood pressure (15%, p<0.01). The quality of life was worse in individuals with hearing disorders, as measured with the EuroQol EQ-VAS (60.93 ± 1.38 vs. 71.75 ± 0.45, p< 0.0001), but it improved among those who used hearing aids as compared to those who did not use them (59.59 ± 1.52, p<0.01). Conclusions: Hearing disorders are relevant in elderly individuals and they affect their perceived quality of life in a noticeable manner. In addition, they are associated with other clinical, functional and cognitive problems. Nevertheless, the intervention with hearing aids reverses that perception.

Exposing cardiomyocytes to subclinical concentrations of doxorubicin rapidly reduces their creatine transport.

Doxorubicin is commonly used to treat leukemia, lymphomas, and solid tumors, such as soft tissue sarcomas or breast cancer. A major side effect of doxorubicin therapy is dose-dependent cardiotoxicity. Doxorubicin's effects on cardiac energy metabolism are emerging as key elements mediating its toxicity. We evaluated the effect of doxorubicin on [(14)C]creatine uptake in rat neonatal cardiac myocytes and HL-1 murine cardiac cells expressing the human creatine transporter protein. A significant and irreversible decrease in creatine transport was detected after an incubation with 50-100 nmol/l doxorubicin. These concentrations are well below peak plasma levels (5 µmol/l) and within the ranges (25-250 nmol/l) for steady-state plasma concentrations reported after the administration of 15-90 mg/m(2) doxorubicin for chemotherapy. The decrease in creatine transport was not solely because of increased cell death due to doxorubicin's cytotoxic effects. Kinetic analysis showed that doxorubicin decreased V(max), K(m), and creatine transporter protein content. Cell surface biotinylation experiments confirmed that the amount of creatine transporter protein present at the cell surface was reduced. Cardiomyocytes rely on uptake by a dedicated creatine transporter to meet their intracellular creatine needs. Our findings show that the cardiomyocellular transport capacity for creatine is substantially decreased by doxorubicin administration and suggest that this effect may be an important early event in the pathogenesis of doxorubicin-mediated cardiotoxicity.

AMPK and substrate availability regulate creatine transport in cultured cardiomyocytes.

Profound alterations in myocellular creatine and phosphocreatine levels are observed during human heart failure. To maintain its intracellular creatine stores, cardiomyocytes depend upon a cell membrane creatine transporter whose regulation is not clearly understood. Creatine transport capacity in the intact heart is modulated by substrate availability, and it is reduced in the failing myocardium, likely adding to the energy imbalance that characterizes heart failure. AMPK, a key regulator of cellular energy homeostasis, acts by switching off energy-consuming pathways in favor of processes that generate energy. Our objective was to determine the effects of substrate availability and AMPK activation on creatine transport in cardiomyocytes. We studied creatine transport in rat neonatal cardiomyocytes and HL-1 cardiac cells expressing the human creatine transporter cultured in the presence of varying creatine concentrations and the AMPK activator 5-aminoimidazole-4-carboxamide-1-ß-d-ribonucleoside (AICAR). Transport was enhanced in cardiomyocytes following incubation in creatine-depleted medium or AICAR. The changes in transport were due to alterations in V(max) that correlated with changes in total and cell surface creatine transporter protein content. Our results suggest a positive role for AMPK in creatine transport modulation for cardiomyocytes in culture.