An analysis of omega-3 clinical trials and a call for personalized supplementation for dementia prevention.

INTRODUCTION: Targeted interventions are needed to delay or prevent the onset of neurodegenerative diseases. Poor dietary habits are associated with cognitive decline, highlighting the benefits of a healthy diet with fish and polyunsaturated fatty acids (PUFAs). Intake of omega-3 PUFAs docosahexaenoic acid (DHA), α-linolenic acid (ALA) and eicosapentaenoic acid (EPA) is linked with healthy aging, cardiovascular benefits, and reduced risk of Alzheimer's disease. Although omega-3 has health benefits, its intake is often inadequate and insufficient in modern diets. Although fish oil supplements offer an alternative source, inconsistent results from clinical trials raise questions about the factors determining their success. AREAS COVERED: In this this review, the authors discuss the aforementioned determining factors and highlight strategies that could enhance the effectiveness of omega-3 PUFAs interventions for dementia and cognitive decline. Moreover, the authors provide suggestions for potential future research. EXPERT OPINION: Factors such as diet, lifestyle, and genetic predisposition can all influence the effectiveness of omega-3 supplementation. When implementing clinical trials, it is crucial to consider these factors and recognize their potential impact on the interpretation of results. It is important to study each variable independently and the interactions between them.

Self-reported glaucoma prevalence and related factors, contribution to reported visual impairment, and functional burden in a cross-sectional study in Colombia.

PURPOSE: Describe the self-reported prevalence of glaucoma in Colombian older adults, emphasizing the most important risk factors and associated daily-life functional alterations. METHODS: This a secondary analysis of the Health, Wellness, and Aging survey conducted in the year 2015. Diagnosis of glaucoma was obtained from self-report. Functional variables were assessed through activities of daily living questionnaires. A descriptive analysis followed by bivariate and multivariate regression models adjusting for confounding variables was conducted. RESULTS: Self-reported prevalence of glaucoma was 5.67%, with higher rate in women, OR 1.22 (1.13-1.40) p = .003, older age OR 1.02 (1.01-1.02) p < .001, and with higher education OR 1.38 (1.28-1.50) p < .001. Glaucoma was independently associated with diabetes OR 1.37 (1.18-1.61) p < .001 and hypertension 1.26 (1.08-1.46) p = .003. It also showed statistically significant correlations with poor SRH OR 1.15 (1.02-1.32) p < .001, self-reported visual impairment 1.73 (1.50-2.01) p < .001, and impairment in money management OR 1.59 (1.16-2.08) p = .002, grocery shopping OR 1.57 (1.26-1.96) p < .001 and preparing meals OR 1.31 (1.06-1.63) p = .013 and having had falls during the last year OR 1.14 (1.01-1.31) p = 0.041. CONCLUSION: Our findings suggest the self-reported prevalence of glaucoma in older adults in Colombia to be higher than reported data. Glaucoma and visual impairment in older adults represent a public health concern, since glaucoma was associated with adverse outcomes like functional loss and risk of falling, affecting the quality of life and their participation in society.

Specific depressive symptoms are related with different patterns of alcohol use in community-dwelling older adults.

OBJECTIVES: To explore how individual depressive symptoms might contribute to different patterns of alcohol consumption in Colombian older adults living in the community. METHODS: A Secondary analysis from a nationally representative cross-sectional study of more than 23,000 older adults, with data from 19,004 participants. Drinking frequency, and level (moderate or heavy drinking) were used to assess alcohol use and depressive symptoms explored with the 15 items-GDS., using bivariate and multivariate adjusted regression models. RESULTS: Lower weekly drinking frequency and a higher number of drinks per serving were associated with total GDS score. For individual symptoms, higher drinking frequency was associated with dropping activities and a preference to stay at home. Lower drinking frequency was associated with low mood, unhappiness, feelings of emptiness, worthlessness, hopelessness, and a lack of vigour. Lower number of drinks per serving was associated with withdrawal/apathy related symptoms; these also related to higher frequency of weekly alcohol consumption. Higher number of drinks per serving was associated with feelings of emptiness, worthlessness, boredom, helplessness, worthlessness. not wanting to be alive, thinking that other people are better off in their mood, being afraid that something bad will happen and subjective memory problems. Moderate drinkers had a higher likelihood of reporting lack of vigour. CONCLUSION: There were diverse patterns of alcohol use according to individual depressive symptoms. This has implications for interventions to reduce alcohol related harm in older people across a range of depressive symptoms with different patterns of alcohol use.

Síntomas depresivos y prevalencia de fragilidad en adultos mayores colombianos. Análisis secundario de la encuesta SABE Colombia 2015

Objetivo: Analizar la relación entre los síntomas depresivos y la prevalencia de fragilidad medida como fenotipo de fragilidad. Materiales y métodos: Estudio secundario de la encuesta SABE Colombia 2015. Se utilizaron las puntuaciones de la escala Yesavage como variable independiente, la prevalencia de fragilidad calculada con el fenotipo de fragilidad de Fried. Realizamos un análisis descriptivo y bivariado de la muestra, seguido de un análisis multivariado ajustando por variables de confusión. Resultados: Analizamos información de un total de 19 004 participantes mayores de 60 años, participantes sin deterioro cognitivo de la encuesta, a quienes se les administró la escala Yesavage. La media de edad fue 69.25 años, el 56 % de los participantes eran mujeres, la prevalencia de fragilidad fue del 12 % y se encontró síntomas depresivos en 57,4 % de la muestra. En el análisis multivariado encontramos asociaciones estadísticamente significativas entre las puntuaciones más altas de la escala Yesavage y la presencia de fragilidad (Yesavage 5-10) OR 1.20 (0.98-1.46) p valor 0.066 y (Yesavage >10) 2.05 (1.46-2.89) <0.001 después de ajustar por edad, sexo, comorbilidades, funcionalidad, escolaridad y estado marital Conclusiones: Nuestro estudio muestra asociaciones estadísticamente significativas entre la presencia de síntomas depresivos medidos con la escala Yesavage y la prevalencia de fragilidad según el índice de Fried. Aunque existe escasa evidencia en cuanto a la asociación de estas dos entidades en Latinoamérica, nuestros resultados son consistentes con estudios previos en la región.

Objetive: There is scarce evidence in Latin America that describes depression in the elderly population with fragility. The aim of this paper is to provide a better understanding of the relationship between depressive symptoms in elderly and the prevalence of frailty. Material and methods: We performed secondary analysis of the SABE Colombia 2015 survey. The Yesavage scale scores were used as an independent variable, the prevalence of frailty was estimated with the Fried fragility phenotype. We performed a descriptive and bivariate analysis of the sample, followed by a multivariate analysis adjusting for confounding variables. Results: We analyzed information from a total of 19,004 participants over 60 years of age, participants without cognitive impairment of the survey, who were administered the Yes-avage scale. The mean age was 69.25 years, 56 % of the participants were women, the prevalence of frailty was 12 % and depressive symptoms were found in 57.4 % of the sample. In the multivariate analysis we found statistically significant associations between frailty and the higher Yesavage scores (score 5-10) OR 1.20 (0.98-1.46) p valor 0.066 and (score> 10) 2.05 (1.46-2.89) <0.001 after adjusting for age, sex, comorbidities, functionality, schooling and marital status. Conclusions: Our study shows an independent relationship between depressive symptoms and frailty phenotype in the SABE Colombia 2015s survey There is lack of data and characterization of this population in Latin America regarding the relationship of these conditions, however our results are consistent with previous reports from this region.

Tongue muscle mass is associated with total grey matter and hippocampal volumes in Dementia with Lewy Bodies.

BACKGROUND: Age-related neurodegeneration, sarcopenia, and ectopic fat accumulation are conditions with shared pathways that remain poorly understood. We have measured muscle volume and fat accumulation in masseter and tongue muscle, and aim to explore their association with the total grey matter volume using MRI in older adults recently diagnosed with Alzheimer's disease (AD) and Dementia with Lewy bodies (DLB). METHODS: In this cross-sectional study, people newly diagnosed with mild AD (n=33) and DLB (n=20) underwent structural head MRI. Muscle volume and intramuscular fat (iMAT) of the tongue and masseter were computed using Slice-O-Matic software for segmentation. Total grey volume and hippocampal volumetric segmentation were performed with the FreeSurfer image analysis suite version 6.0. Independent regression models were employed to analyse the associations. RESULTS: Tongue iMAT was higher and total grey volume lower in DLB compared to AD. In the DLB group, tongue muscle was positively associated with total grey matter volume Est 0.92 (SE 0.24 p-value 0.002), left- Est 0.01 (SE 0.0028 p-value 0,002), and right- Est 0.0088 (SE 0.0027 p-value: 0.005) hippocampal volume. There were no statistically significant results for AD. CONCLUSION: Tongue muscle volume was positively associated with hippocampal and total grey volume in DLB. Longitudinal designs are required to explore the extent and significance of this association.

Polypharmacy is associated with functional decline in Alzheimer's disease and Lewy body dementia.

BACKGROUND: In dementia, a number of factors may influence functional decline in addition to cognition. In this study, we aimed to study the potential association of the number of prescribed medications with functional decline trajectories over a five-year follow-up in people diagnosed with mild Alzheimer's disease (AD) or Lewy Body dementia (LBD). METHODS: This is a longitudinal analysis of a Norwegian cohort study entitled "The Dementia Study of Western Norway". We included 196 patients newly diagnosed with AD (n=111) and LBD (n=85), followed annually for 5 years. We conducted linear mixed-effects models to analyse the association of the number of medications with functional decline measured by the Rapid Disability Rating Scale - 2. RESULTS: The mean prescribed medications at baseline was 4.18∓2.60, for AD 3.92∓2.51 and LBD 4.52∓2.70. The number of medications increased during the follow-up; at year five the mean for AD was 7.28∓4.42 and for LBD 8.11∓5.16. Using more medications was associated with faster functional decline in AD (Est 0.04, SE 0.01, p-value 0.003) and LBD (Est 0.08, SE 0.03, p-value 0.008) after adjusting for age, sex, comorbidity, neuropsychiatric symptoms, and cognition. For each medication added during the follow-up, functional trajectories worsened by 1% for AD and 2% for LBD. The number of medications was not associated with cognitive decline. CONCLUSION: We found that higher number of medications was related to a faster functional decline, both in AD and LBD. With disease progression, there was an increase in the number of medications. Prescription in dementia should be carefully assessed, possibly improving the functional prognosis.

Delirium prevalence in a Colombian hospital, association with geriatric syndromes and complications during hospitalization.

BACKGROUND: The aim of this paper is to describe the prevalence of Delirium and the factors associated with its presentation and complications identified in a geriatric unit in Colombia. MATERIAL AND METHODS: This is a retrospective observational study that included all patients admitted consecutively for two years in a geriatric unit of a hospital in Bogotá, Colombia. We assessed delirium prevalence with the Confusion Assessment Method (CAM). The independent variables were age, sex, functional impairment (Barthel<90), malnutrition (MNA<12), pressure ulcers at admission, state of the social support network, number of comorbidities, polypharmacy (5 or more drugs), complications such as ICU requirement, hospital stay, in-hospital functional impairment and mortality were also evaluated. As an exclusion criterion: not having CAM registered in the medical record, all the patients had this information. RESULTS: We studied 1599 subjects with a mean age of 86 years (IQR 9). Delirium prevalence was 51.03%. Delirium was associated with a higher rate of: pressure ulcers on admission [OR 3.76 (CI 2.60-5.43 p<0.001)], functional impairment [OR 2.38 (CI 1.79-3.16 p<0.001)], malnutrition [OR 2.06 (CI 1.56-2.73 p<0.001)], and infection [OR 1.46 (CI 1.17-1.82 p<0.001)]. Moreover delirium has a higher association with mortality [OR 2.80 (1.03-7.54 p=0.042)], in-hospital functional decline [OR 1.82 (1.41-2.36 p<0.001)], and longer hospital stay [OR 1.04 (1.04-1.09 p=0.006)]; independently of age, sex, pressure ulcers on admission, functional impairment, malnutrition, dementia, infection and limited social network. CONCLUSION: Our study suggests that infectious diseases and geriatric syndromes such as, functional dependence, pressure ulcers, malnutrition or major cognitive impairment are independently associated with the presence of delirium on admission. Additionally, the presence of delirium is independently associated during hospitalization with complications, longer hospital stay, functional impairment and mortality.

Factors associated with functional loss among community-dwelling Mexican older adults. / Factores asociados con el deterioro funcional en adultos mayores mexicanos

INTRODUCTION: Functional status decline is related to many negative outcomes. OBJECTIVE: To explore the relationship of sociodemographic, medical, and psychological factors with the incidence of functional status decline in Mexican older adults. MATERIALS AND METHODS: Data from the 2012 and 2015 waves of the Mexican Health and Aging Study (MHAS) survey were analyzed. Participants with previous functional status decline at baseline were excluded. We assessed functional status decline individually with activities of daily living (ADL) and instrumental ADL (IADLs) in an individual way. RESULTS: Age was associated with functional limitations in ADL. Being male had an association with limitations for IADL. A poor financial situation and lower education related to higher limitations for ADL. Furthermore, pain, comorbidities, and depression were found to be independently associated with limitations in ADL. IADL limitation was associated with age, poor education, comorbidities, and depression, as well as cognitive impairment. CONCLUSIONS: We found that factors such as age, financial status, educational level, pain, and the number of comorbidities were associated with the incidence of functional status decline. Pain had a greater association in the 3-year functional ADL decline incidence when compared with cognitive impairment. Studying functional decline by domains allowed us to find more detailed information to identify factors susceptible to intervention with the aim to reduce the incidence of functional status decline and dependence.

Introducción. El deterioro funcional está relacionado con muchos resultados adversos. Objetivo. Explorar la relación de los factores sociodemográficos, médicos y psicológicos con la incidencia del deterioro funcional en los adultos mayores mexicanos. Materiales y métodos. Se analizaron los datos de las cohortes de 2012 y 2015 de la encuesta del Estudio Mexicano de Salud y Envejecimiento. Se excluyeron los participantes con discapacidad funcional en el período de referencia (2012). Se evaluó de forma individual el deterioro funcional en las actividades básicas de la vida diaria (AVD) y en las instrumentales (AIVD). Resultados. Se encontró que el dolor, las comorbilidades, el nivel educativo, el estatus socioeconómico y la depresión se asociaban independientemente con el deterioro de las AVD. El deterioro de las AIVD se asoció con la edad, la educación deficiente, las comorbilidades, la depresión y el deterioro cognitivo. Conclusiones. La edad, el sexo, el estado financiero, el nivel educativo, el dolor y el número de comorbilidades se asociaron con la incidencia del deterioro funcional. El dolor tuvo una mayor asociación con la incidencia del deterioro funcional en las AVD a los tres años, en comparación con el deterioro cognitivo. El estudio del deterioro funcional por dominios permitió recabar información más detallada para determinar los factores que pueden intervenirse con el objetivo de reducir la incidencia del deterioro funcional y la dependencia.

Factors associated with functional loss among community-dwelling Mexican older adults / Factores asociados con el deterioro funcional en adultos mayores mexicanos

Introduction: Functional status decline is related to many negative outcomes. Objective: To explore the relationship of sociodemographic, medical, and psychological factors with the incidence of functional status decline in Mexican older adults. Materials and methods: Data from the 2012 and 2015 waves of the Mexican Health and Aging Study (MHAS) survey were analyzed. Participants with previous functional status decline at baseline were excluded. We assessed functional status decline individually with activities of daily living (ADL) and instrumental ADL (IADLs) in an individual way. Results: Age was associated with functional limitations in ADL. Being male had an association with limitations for IADL. A poor financial situation and lower education related to higher limitations for ADL. Furthermore, pain, comorbidities, and depression were found to be independently associated with limitations in ADL. IADL limitation was associated with age, poor education, comorbidities, and depression, as well as cognitive impairment. Conclusions: We found that factors such as age, financial status, educational level, pain, and the number of comorbidities were associated with the incidence of functional status decline. Pain had a greater association in the 3-year functional ADL decline incidence when compared with cognitive impairment. Studying functional decline by domains allowed us to find more detailed information to identify factors susceptible to intervention with the aim to reduce the incidence of functional status decline and dependence.

Introducción. El deterioro funcional está relacionado con muchos resultados adversos. Objetivo. Explorar la relación de los factores sociodemográficos, médicos y psicológicos con la incidencia del deterioro funcional en los adultos mayores mexicanos. Materiales y métodos. Se analizaron los datos de las cohortes de 2012 y 2015 de la encuesta del Estudio Mexicano de Salud y Envejecimiento. Se excluyeron los participantes con discapacidad funcional en el período de referencia (2012). Se evaluó de forma individual el deterioro funcional en las actividades básicas de la vida diaria (AVD) y en las instrumentales (AIVD). Resultados. Se encontró que el dolor, las comorbilidades, el nivel educativo, el estatus socioeconómico y la depresión se asociaban independientemente con el deterioro de las AVD. El deterioro de las AIVD se asoció con la edad, la educación deficiente, las comorbilidades, la depresión y el deterioro cognitivo. Conclusiones. La edad, el sexo, el estado financiero, el nivel educativo, el dolor y el número de comorbilidades se asociaron con la incidencia del deterioro funcional. El dolor tuvo una mayor asociación con la incidencia del deterioro funcional en las AVD a los tres años, en comparación con el deterioro cognitivo. El estudio del deterioro funcional por dominios permitió recabar información más detallada para determinar los factores que pueden intervenirse con el objetivo de reducir la incidencia del deterioro funcional y la dependencia.

Asociación entre pérdida del apetito y niveles de albúmina en adultos mayores con enfermedad de Alzheimer leve / Relationship between loss of appetite and albumin levels in older adults with mild Alzheimer's disease

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Association between self-reported hearing impairment, use of a hearing aid and performance of instrumental activities of daily living.

BACKGROUND AND PURPOSE: Age-related hearing loss is a prevalent condition among the growing elderly population, which has been associated with both cognitive decline and decreased daily functioning. Decreased functioning is linked to lower performance, predominantly regarding instrumental activities of daily living (IADLs). The present study aims to explore the association between hearing loss and impairment in IADLs. METHODS: This is a secondary analysis of The Health, Well-Being, and Aging Colombia study, performed in 2015. Participants were classified into three groups: 1) without hearing loss, 2) hearing loss corrected through the use of a hearing aid, and 3) hearing loss without a hearing aid. Bivariate and adjusted multivariate analyses were performed. The measured outcome was IADLs. RESULTS AND DISCUSSION: Information from a total of 23,694 community-dwelling Colombian older adults (age ≥ 60 years) was used. The prevalence of hearing impairment was 23.4%, 1.8% out of those reported the use of hearing aids. Independent associations were found for having impaired IADLs when comparing participants with hearing loss without a hearing aid and those with normal hearing. However, there was no statistical significance with respect to IADLs when comparing hearing loss corrected by hearing aids versus participants with normal hearing. Participants using hearing aids have better functioning evaluated by IADLs when compared with participants with hearing impairment and no hearing aids. CONCLUSION: This study evidences a positive association between hearing impairment and performance in the IADLs. This association is not significant in older adults using hearing aids.

Caregiver burden in caregivers of hospitalized older adults and its associated factors / Sobrecarga do cuidador em cuidadores de idosos hospitalizados e seus fatores associados

AIM: Acute care has some complications in the older adult, a frequently overlooked complication is caregiver burden. Scarce information is available on this matter. Therefore, the objective is to describe the factors associated with caregiver burden at the moment of discharge of a hospitalized older adult, in the Mexican healthcare context. METHOD: This is a secondary analysis of a hospital. Bivariate and multivariate analyses were performed with caregiving burden (measured with the Zarit scale) as the dependent variable. Other variables were tested in order to assess their association with caregiver burden: sociodemographic, health-related, depression, functionality, social support and hospital length of stay, caregiver expenses, quality of life and satisfaction with received care. RESULTS: A total of 111 older adults with their respective caregivers were assessed. From this sample, the mean age for older adults was 73 years (± standard deviation 7.9 years) and 65.7% (n = 73) were women. Caregiver burden was present in 39.6% (n = 44) of the individuals. Regarding the multivariate analyses, the only variable independently associated with caregiver burden was depression in the older adult, odds ratio 1.12 (95% confidence interval 1­1.25, p = 0.045). CONCLUSIONS: In concordance with previous work on this matter, according to our results depression in the older adult was a trigger of caregiver burden at discharge of acute care.

OBJETIVO: Os cuidados intensivos têm algumas complicações em idosos, e uma frequentemente negligenciada é a sobrecarga do cuidador, sobre a qual pouca informação está disponível. Desse modo, o objetivo deste trabalho é descrever os fatores associados com a sobrecarga do cuidador na alta hospitalar de um paciente idoso no contexto médico mexicano. METODOLOGIA: Esta é uma análise secundária de um hospital. Foram realizadas análises bivariadas e multivariadas tendo a sobrecarga do cuidador (medida com a escala de Zarit) como variável dependente. Outras variáveis foram testadas com o propósito de avaliar a sua associação com a sobrecarga do cuidador: sociodemográficas, de saúde, depressão, funcionalidade, apoio social e duração da estadia hospitalar, despesas do cuidador, qualidade de vida e satisfação com o cuidado recebido. RESULTADOS: Ao todo, 111 idosos com seus cuidadores foram avaliados. Dessa amostra, a idade média dos idosos foi de 73 anos (± desvio-padrão de 7,9 anos) e 65,7% (n=73) eram mulheres. A sobrecarga do cuidador estava presente em 39,6% (n=44) dos indivíduos. Com relação às análises multivariadas, a única variável independentemente associada com a sobrecarga do cuidador foi a depressão nos idosos, com razão de probabilidade de 1,12 (95% intervalo de confiança 1­1.25, p = 0.045). CONCLUSÕES: Em conformidade com trabalhos anteriores realizados sobre este assunto, de acordo com os nossos resultados a depressão nos idosos foi um gatilho para a sobrecarga do cuidador na alta dos cuidados intensivos.

Edentulism and its relationship with self-rated health: secondary analysis of the SABE Ecuador 2009 Study.

Edentulism is related to a number of conditions in older adults, impacting their overall health status and thus their quality of life and relationship with the environment. At the same time, self-rated health has been shown to be an accurate marker of overall health status. However there is little information on how edentulism relates to self-rated health in older adults of Hispanic origin. The aim of this study was to evaluate the impact of edentulism on self-rated health in older adults. We analyzed data from SABE Ecuador 2009, a cross-sectional study that included a probabilistic representative sample of 5, 235 community-dwelling older adults aged 60 years or older. The dependent variable was self-rated health and the independent variable was edentulism, with age, sex and comorbidities as confounding variables. In order to test the independent association of edentulism with self-rated health, a logistic regression model was fitted. Out of the whole sample, 77. 13% of older adults reported having fair/poor self-rated health. We found an independent association between edentulism and self-rated health with incremental risk according to number of missingteeth, ranging from OR 1. 35 (CI 95% 0. 75 - 2. 43) p 0. 32 for less than 4 missing teeth to OR 1. 88(1. 06 - 3. 32) p 0. 029for more than half of teeth missing. Even though oral health has long been considered separately from the rest of the body and mind, it is clear from our results that oral health is a very important component of global health status in the elderly.

El edentulismo se ha asociado con una gran variedad de condiciones en los adultos mayores afectando el estado general de su salud. Por lo tanto, afecta la calidad de vida de la persona y su relación con el medio ambiente. Por otro lado, la autoevaluación de la salud ha demostrado ser un marcador preciso del estado general de la salud. Sin embargo, hay escasa información sobre cómo estas dos condiciones se relacionan entre sí en adultos mayores de origen hispano. El objetivo de este estudio fue evaluar el impacto del edentulismo en la autoevaluación de la salud en adultos mayores. Se analizaron los datos de SABE Ecuador 2009, un estudio transversal que incluyó una muestra probabilística y representativa de 5. 235 personas de 60 anos de edad o más. La variable dependiente fue la salud autoevaluada y edentulismo fue la variable independiente, teniendo edad, sexo y comorbilidades como variables de confusión. Con el fin de probar la asociación independiente de edentulismo con la auto-evaluación de la salud un modelo de regresión logística se ajustó. De la muestra entera, un 77, 13% de los adultos mayores reportaron tener salud auto-evaluada regular / pobre. Se encontró una asociación independiente entre edentulismo y salud autoevaluada con un riesgo incremental dependiendo del número de dientes ausentes de OR 1, 35 (IC 95% 0, 75 - 2, 43) p 0, 32, en adultos mayores con menos de 4 dientes ausentes hasta OR 1, 88 (1, 06 - 3, 32) p 0, 029, con más de la mitad de dientes ausentes. La salud oral se ha considerado de forma independiente del resto del cuerpo y la mente, es claro por nuestros resultados que la salud oral es un componente muy importante del estado de salud global en las personas mayores.

Edentulism and its relationship with self-rated health: secondary analysis of the SABE Ecuador 2009 study / Relación del edentulismo con la autoevaluación del estado de la salud: un análisis secundario del estudio SABE Ecuador 2009

Edentulism is related to a number of conditions in older adults, impacting their overall health status and thus their quality of life and relationship with the environment. At the same time, selfrated health has been shown to be an accurate marker of overall health status. However there is little information on how edentulism relates to selfrated health in older adults of Hispanic origin. The aim of this study was to evaluate the impact of edentulism on selfrated health in older adults. We analyzed data from SABE Ecuador 2009, a crosssectional study that included a probabilistic representative sample of 5,235 communitydwelling older adults aged 60 years or older. The dependent variable was selfrated health and the independent variable was edentulism, with age, sex and comorbidities as confounding variables.In order to test the independent association of edentulism with selfrated health, a logistic regression model was fitted. Out of the whole sample,77.13% of older adults reported having fair/poor selfrated health. We found an independent association between edentulism and selfrated health with incremental risk according to number of missingteeth,ranging from OR 1.35 (CI 95% 0.75 2.43) p 0.32 for less than 4 missing teeth to OR 1.88(1.06 3.32) p 0.029 for more than half of teeth missing. Even though oral health has long been considered separately from the rest of the body and mind, it is clear from our results that oral health is a very important component of global health status in the elderly (AU)

El edentulismo se ha asociado con una gran variedad de condiciones en los adultos mayores afectando el estado general de su salud. Por lo tanto, afecta la calidad de vida de la persona y su relación con el medio ambiente. Por otro lado, la autoevaluación de la salud ha demostrado ser un marcador preciso del estado general de la salud. Sin embargo, hay escasa información sobre cómo estas dos condiciones se relacionan entre sí en adultos mayores de origen hispano. El objetivo de este estudio fue evaluar el impacto del edentulismo en la autoevaluación de la salud en adultos mayores. Se analizaron los datos de SABE Ecuador 2009, un estudio transversal que incluyó una muestra probabilística y representativa de 5.235 personas de 60 años de edad o más. La variable dependiente fue la salud autoevaluada y edentulismo fue la variable independiente, teniendo edad, sexo y comorbilidades como variables de confusión. Con el fin de probar la asociación independiente de edentulismo con la autoevaluación de la salud un modelo de regresión logística se ajustó. De la muestra entera, un 77,13% de los adultos mayores reportaron tener salud autoevaluada regular / pobre. Se encontró una asociación independiente entre edentulismo y salud autoevaluada con un riesgo incremental dependiendo del número de dientes ausentes de OR 1,35 (IC 95% 0,75 2,43) p 0,32, en adultos mayores con menos de 4 dientes ausentes hasta OR 1,88 (1,06 3,32) p 0,029, con más de la mitad de dientes ausentes. La salud oral se ha considerado de forma independiente del resto del cuerpo y la mente, es claro por nuestros resultados que la salud oral es un componente muy importante del estado de salud global en las personas mayores (AU)