Construcción de la alimentación en trayectorias vitales de personas mayores

Introducción: La alimentación se construye a partir de experiencias y significados adquiridos en el curso de la vida. Las personas mayores tienen un acervo importante que informa de valores y prácticas culturales aplicadas a la alimentación. El objetivo del estudio fue interpretar los significados que entregan personas mayores a la construcción de su alimentación en trayectorias del curso de vida. Métodos: La investigación utilizó un enfoque cualitativo de alcance exploratorio, utilizando el método de teoría fundamentada de Strauss y Corbin. Para la recolección de datos se aplicó una entrevista semiestructurada entre julio de 2021 y junio de 2022. El tipo de muestreo fue teórico y el análisis de los datos cualitativos respondió al proceso de codificación abierta, axial y selectiva. Resultados: Participaron 54 personas mayores (72% mujeres) con edad promedio de 68,6 años (6,9 años). Las personas mayores construyeron su alimentación con un alto significado a las comidas caseras, con influencia de género femenino durante la niñez y adolescencia. En la adultez, se reconstruye la alimentación al ingresar al mundo laboral. En la actualidad, cimentan la alimentación con un enfoque de cuidados para su salud. Reconocen transiciones y puntos de inflexión en la alimentación provocados por terremotos, pandemia por COVID-19, situación política en el país, embarazos o el diagnóstico de alguna enfermedad crónica. Discusión: Las personas mayores reconocen diversas vivencias en trayectorias vitales que han marcado sus patrones alimentarios. Estas experiencias de vida pueden ser la base de estrategias o acciones en la práctica clínica que aporten a su bienestar.

Introduction: Food is intricately woven into the fabric of our experiences and the meanings accumulated throughout life. Older people possess a rich cultural heritage that shapes the values and practices surrounding food.The aim of the study was to interpret the meanings attributed to older people to the construction of their feeding in life course trajectories. Methods: The research employed a qualitative exploratory approach, utilizing the Grounded Theory method developed by Strauss and Corbin. Data collection took place through semi-structured interviews conducted between July 2021 and June 2022. The sampling method employed was theoretical, and the analysis of qualitative data followed the open, axial, and selective coding process. Results: A total of 54 older individuals (72% women), with an average age of 68.6 years (6,9 years), participated in the study. These individuals constructed their relationship with food, assigning significant value to homemade meals, influenced by gender roles during childhood and adolescence. In adulthood, the relationship with food transformed with entry into the workforce. Currently, their feeding are guided by a health-centric approach. They recognize transitions and turning pointsin food provoked by earthquakes, pandemic by COVID-19, political situation in the country, pregnancies or the diagnosis of a chronic disease. Discussion: Older people recognize a multitude of life experiences that have left imprints on their eating patterns. These life experiences can be the basis for strategies or actions in clinical practice that contribute to their well-being.

Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009-2010.

OBJECTIVE: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. DESIGN: Prospective study. SETTINGS: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points) and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. PARTICIPANTS: 2706 participants from the Chilean National Health Survey 2009-2010. RESULTS: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. CONCLUSION: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Multimorbidity and 11-year mortality in adults: a prospective analysis using the Chilean National Health Survey.

Research on morbidity and mortality often emphasizes individual diseases over the cumulative effects of multimorbidity, especially in low- and middle-income countries. This study aimed to analyze the association between multimorbidity and all-cause mortality in a representative sample of the Chilean population. This longitudinal study used data from 3701 subjects aged ≥15 years who participated in the Chilean National Health Survey conducted between 2009 and 2010. We included 16 self-reported highly prevalent morbidities. All-cause mortality data from an 11-year follow-up were collected from the Chilean Civil Registry. The Cox proportional hazard model, adjusted for confounders, determined the association between multimorbidity categories and all-cause mortality. Of the total sample, 24.3% reported no morbidity, while 50.4% two or more. After adjustment, participants with four or more morbidities had a 1.66 times higher mortality risk [95% confidence interval (CI): 1.03-2.67] than those without morbidities. The mortality risk increased by 10% for each additional morbidity [HR: 1.09 (CI: 1.04-1.16)]. Multimorbidity was common in the Chilean population and increased the mortality risk, which greatly challenges the health system to provide an integral and coordinated approach to healthcare.

Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults.

Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.

A copper(ii) peptide helicate selectively cleaves DNA replication foci in mammalian cells.

The use of copper-based artificial nucleases as potential anticancer agents has been hampered by their poor selectivity in the oxidative DNA cleavage process. An alternative strategy to solve this problem is to design systems capable of selectively damaging noncanonical DNA structures that play crucial roles in the cell cycle. We designed an oligocationic CuII peptide helicate that selectively binds and cleaves DNA three-way junctions (3WJs) and induces oxidative DNA damage via a ROS-mediated pathway both in vitro and in cellulo, specifically at DNA replication foci of the cell nucleus, where this DNA structure is transiently generated. To our knowledge, this is the first example of a targeted chemical nuclease that can discriminate with high selectivity 3WJs from other forms of DNA both in vitro and in mammalian cells. Since the DNA replication process is deregulated in cancer cells, this approach may pave the way for the development of a new class of anticancer agents based on copper-based artificial nucleases.

Azathioprine in hidradenitis suppurativa with inflammatory phenotype: a case series of 11 patients.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that negatively impacts the quality of life of patients. It presents as deep-seated nodules, abscesses, fistulae, sinus tracts, and scars in the axilla, inguinal area, submammary folds, and perianal area. Recently, two phenotypes have been described: a follicular phenotype and an inflammatory phenotype. Numerous medical treatments are available for hidradenitis suppurativa, with particular importance of antitumor necrosis factor antibodies. Due to the association of HS with other conditions with a pro-inflammatory state, particularly Crohn's disease, it has been suggested that azathioprine may have a role in the treatment of HS. OBJECTIVE: To assess the effectiveness of azathioprine monotherapy in patients with moderate-severe HS. METHODS: We retrospectively studied patients with HS treated with azathioprine in monotherapy. We performed both clinical and ultrasound evaluation at baseline as well as in the follow-up visits. Their baseline score on the iHS4 and DLQI scales and 12-16 weeks after starting the treatment were compared. We also registered the number of patients who achieved HiSCR. RESULTS: Six patients presented significant improvement, reducing their score in iHS4 and DLQI scales and achieving HiSCR. Another patient had clinical improvement, meaning reduction in iHS4 and DLQI, but without achieving HiSCR. Two patients stopped the treatment before week 12 because of adverse events. The remaining two patients presented no improvement. The median (Q3-Q1) baseline iHS4 score was 6 (12-6), and follow-up iHS4 score, 4 (6-2), being these differences statistically significant (P = 0.006). Median (Q3-Q1) baseline DLQI scores and 12-16 weeks after treatment were 17 (23-11) and 14 (18-9) although statistically nonsignificant (P = 0.099). CONCLUSION: We present a case series of 11 patients treated with azathioprine with good clinical and ultrasonographic response. We suggest that azathioprine may benefit a certain patient profile with the inflammatory phenotype.

Efecto del sedentarismo sobre la interacción entre el gen FTO y niveles de adiposidad en adultos chilenos - Resultados del Estudio GENADIO / Effect of Sedentary behaviors on the Interaction Between the FTO Gene and Adiposity Levels in Chilean Adults - Results from the GENADIO Study

ANTECEDENTES: Tanto el gen FTO (Fat-mass and obesity-associated-gene) y el tiempo sedente se asocian a obesidad, sin embargo, se desconoce si el tiempo sedente puede modificar la predisposición genética a la obesidad. Por ende, el objetivo de este estudio fue investigar si la asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad podrían ser modificados por el tiempo sedente. MÉTODOS: Este estudio de corte transversal incluye a 409 participantes del estudio GENADIO. Los marcadores de adiposidad estudiados fueron peso corporal, índice de masa corporal (IMC), perímetro de cintura (PC) y porcentaje masa grasa. El tiempo sedente se determinó mediante acelerometría de movimiento. La interacción entre el gen FTO (rs9939609) y el tiempo sedente sobre los marcadores de adiposidad se determinó mediante análisis de regresión múltiple. RESULTADOS: Tanto la variante de riesgo del gen FTO como el tiempo sedente se asociaron a mayor peso corporal, IMC, PC y masa grasa. Sin embargo, la asociación entre tiempo sedente y marcadores de adiposidad fue mayor en personas portadoras del alelo de riesgo del gen FTO. Por cada 1 hora de incremento en tiempo sedente, el peso corporal incrementa en 1,36 kg ([95% IC: 0,27; 2,46], p = 0,015) y 2,95 kg ([95% IC: 1,24; 4,65], p = 0,001) en personas con la variante protectora (TT) versus aquellos con la variante de riesgo (AA), respectivamente. Resultados similares se encontraron para (PC). CONCLUSIÓN: La asociación entre la variante de riesgo de FTO y mayor nivel de adiposidad es más acentuada en individuos que presentan mayores niveles de sedentarismo.

BACKGROUND: The Fat-mass and obesity-associated-gene (FTO gene) and sedentary behavior time are associated with obesity. However, whether sedentary behavior time can modify the genetic predisposition to obesity in the Chilean population is unknown. Therefore, this study investigated the association between sedentary behavior, adiposity markers, and the FTO gene. METHODS: This cross-sectional study included 409 participants from the Genes, Environment, Diabetes, and Obesity (GENADIO) study. Adiposity markers studied included body weight, body mass index (BMI), waist circumference (WC), and fat mass. Sedentary behaviors were measured using accelerometers. Using multiple regression, we evaluated the interaction between sedentary behaviors and the FTO gene (rs9939609) on adiposity markers. RESULTS: Sedentary behaviors and the FTO genotype were positively associated with higher body weight, BMI, WC, and fat mass. However, the association between time of sedentary behavior and adiposity markers was higher in carriers of the risk variant for the FTO gene. For each hour of increment in sedentary behaviors, body weight increases by 1.36 kg ([95% CI: 0.27; 2.46], p = 0.015) and 2.95 kg ([95%CI: 1.24; 4.65], p = 0.001) in non-risk carriers (TT) versus risk carriers (AA), respectively. We observed similar results for WC, BMI, and body fat, but the interaction was significant only for WC. CONCLUSION: The association between sedentary behaviors and adiposity markers, especially body weight and WC, is higher in individuals who carry the risk variant of the FTO gene.

Índice de obesidad ABSI y su asociación con diabetes mellitus tipo 2 en adultos chilenos: un estudio transversal de la ENS 2016-2017 / ABSI obesity index and its association with type 2 diabetes mellitus in Chilean adults: a cross-sectional study of the ENS 2016-2017

INTRODUCCIÓN: El nuevo índice de obesidad basado en el volumen corporal (ABSI) ha sido asociado con enfermedades crónicas no transmisibles y mortalidad, independientemente de los valores del índice de masa corporal (IMC); sin embargo, se desconoce su asociación con diabetes mellitus tipo 2 (DMT2) en población chilena. OBJETIVO: determinar la asociación entre ABSI con glicemia, hemoglobina glicosilada (HbAc1) y DMT2 en población adulta chilena. MATERIALES Y MÉTODOS: Estudio transversal, incluyó a 4.874 participantes (edad media 43,3 años, 50,9% mujeres) de la Encuesta Nacional de Salud 2016-2017. ABSI fue calculado según la fórmula propuesta (basado en circunferencia de cintura, IMC y estatura. La Regresión de Poisson fue utilizada para investigar la asociación entre ABSI con DMT2 y regresión lineal para glicemia y HbAc1. Los análisis se ajustaron según factores sociodemográficos, de estilos de vida e IMC. RESULTADOS: ABSI fue positivamente asociado con glicemia (p < 0,001), HbA1c (p < 0,001) y DMT2 (p < 0,001). En el modelo más ajustado, por cada 0.025 unidad de aumento de ABSI, la glicemia aumentó en 1,78 mg/dL (95% IC: 1,21; 2,35) y la HbAc1en un 0,92% (95% IC: 0,49; 1,35). En cuanto a DMT2, la razón de prevalencia fue de 1,14 (95% IC: 1,09; 1,20), independiente de factores sociodemográficos, estilos de vida e IMC. CONCLUSIONES: ABSI se asoció de forma lineal con una mayor probabilidad de padecer DMT2, mayores niveles de glicemia y HbA1c en adultos chilenos. En este contexto, ABSI podría ser un índice complementario, independiente del IMC, para evaluar el riesgo de alteraciones metabólicas asociadas a obesidad.

INTRODUCTION: A Body Shape Index (ABSI) is a new obesity index based on body volume; this has been associated with chronic non-communicable diseases and mortality, independent of the values of the body mass index (BMI); however, its association with type 2 diabetes mellitus (T2DM) in the Chilean adult population is unknown. OBJECTIVE: To determine the association between ABSI, glycemia, glycosylated hemoglobin (HbAc1), and self-reported T2DM in the Chilean adult population. MATERIALS AND METHODS: In a cross-sectional study, 4,874 participants were included (mean age 43.3 years, 50.9% women) from the 2016-2017 National Health Survey. ABSI was calculated according to the proposed formula (based on waist circumference, BMI, and height). The Poisson regression was used to investigate the association between ABSI and T2DM, and linear regression was used to investigate the association between ABSI, glycemia, and HbAc1. Sociodemographic factors, lifestyle, and BMI adjusted the analyses. RESULTS: ABSI was positively associated with glycemia (p < 0.001), HbA1c (p < 0.001), and DMT2 (p < 0.001). In the most adjusted model, for every 0.025 unit increase in ABSI, glycemia increased by 1.78 mg/dL (95% CI: 1.21, 2.35) and HbAc1 by 0.92% (95% CI: 0.49, 1.35). Regarding T2DM, the prevalence ratio was 1.14 (95% CI: 1.09, 1.20), independent of sociodemographic factors, lifestyles, and BMI. CONCLUSIONS: ABSI was linearly associated with a higher probability of suffering from T2DM and higher levels of glycemia and HbA1c in Chilean adults. In this context, ABSI could be a complementary index, independent of BMI, to assess the risk of metabolic disorders associated with obesity.

[Association between oral health and cognitive decline in older Chileans]. / Asociación entre salud oral y deterioro cognitivo en personas mayores chilenas.

OBJECTIVE: To identify the association between oral health and suspected cognitive impairment in older adults in Chile. METHOD: Cross-sectional study including 1826 people ≥60 years who participated in the National Health Survey of Chile, 2016-2017. Oral health was evaluated by the number of teeth, presence of caries, use of dental prostheses, self-reported oral health, and pain and/or discomfort in the oral cavity. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). The association was evaluated by logistic and linear regression, adjusted for sociodemographic and lifestyle variables. RESULTS: Compared with people without suspicion of cognitive impairment, people with suspected impairment had five fewer teeth (13.4 vs. 8.5 teeth), a much higher difference in women than in men, and a higher frequency of oral pain. Edentulism and fewer teeth were associated with a higher likelihood of suspected cognitive impairment, associations that were not maintained in adjusted models. Oral pain was associated with a higher likelihood of suspected impairment even in the most adjusted model (odds ratio: 1.99; 95% confidence interval [95%CI]: 1.09-3.63). In linear models, an increase of 2% (95%CI: 0.01-0.05) in the MMSE score was observed for each additional tooth. CONCLUSIONS: Poor oral health, particularly tooth loss and the presence of pain, was associated with cognitive impairment in older adults in Chile.

Effects of Neuromuscular Training on Physical Performance in Older People: A Systematic Review.

This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were followed. The PEDro scale and Cochrane risk of bias tool were used to assess the quality of and risk of bias in the studies, respectively. The protocol was registered in PROSPERO (code: CRD42022319239). The outcomes were muscle strength, cardiorespiratory fitness, postural balance and gait speed. From 610 records initially found, 10 were finally included in the systematic review, involving 354 older people with a mean age of 67.3 years. Nine of them reported significant changes in at least one variable related to physical performance in the intervention compared to the control groups. The neuromuscular training caused significant improvements in postural balance, flexibility, cardiorespiratory fitness, strength power of the upper and lower limbs and autonomy. The available evidence indicates that neuromuscular training has a positive effect on some variables of physical performance, especially in postural balance; however, the methodological quality and certainty of the evidence in the available literature are limited. Therefore, a greater number of high-quality studies are required to draw definitive conclusions.

Asociación entre bajos niveles de vitamina D y deterioro cognitivo en personas mayores chilenas: Resultados de la Encuesta Nacional de Salud 2016-2017 / Association between low vitamin D levels and cognitive impairment in Chilean older adults: findings of the National Health Survey 2016-2017

INTRODUCTION: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. MATERIAL AND METHOD: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. RESULTS: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. CONCLUSION: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

Frailty Index as a Predictor of Mortality in Middle-Aged and Older People: A Prospective Analysis of Chilean Adults.

We aimed to investigate the association between frailty status and all-cause mortality in middle-aged and older people. We included 2661 individuals aged ≥ 35 from the Chilean National Health Survey 2009−2010. Mortality was determined through linkage with the Chilean Civil Registry and Identification. A 36-item frailty index (FI) was used to assess the frailty status. Associations between frailty status and all-cause mortality were assessed using Kaplan−Meier and Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. A non-linear association was investigated using penalized cubic splines fitted in the Cox models. During an 8.9 median follow-up (interquartile range of 8.6−9.0), 308 individuals died (11.5%). Lower survival rates were observed in frail individuals compared to pre-frail and robust people (log-rank < 0.001). Compared with robust individuals, frail people had a higher mortality risk (HR: 2.35 [95% CI: 1.57 to 3.51]). Frail middle-aged individuals had a higher risk of dying independently of major risk factors.

Asociación entre salud oral y deterioro cognitivo en personas mayores chilenas / Association between oral health and cognitive decline in older Chileans

Objetivo: Identificar la asociación entre salud oral y sospecha de deterioro cognitivo en personas mayores chilenas. Método: Estudio transversal con 1826 participantes ≥60 años de la Encuesta Nacional de Salud de Chile, 2016-2017. La salud oral fue evaluada por el número de dientes, la presencia de caries, el uso de prótesis dental y el autorreporte de salud oral y dolor en la cavidad oral. La sospecha de deterioro cognitivo fue evaluada mediante el Mini-Mental State Examination (MMSE). Se empleó regresión logística y lineal, ajustada por variables sociodemográficas y de estilos de vida. Resultados: En comparación con personas sin sospecha de deterioro cognitivo, aquellas con sospecha de deterioro cognitivo presentaron cinco dientes menos (13,4 vs. 8,5 dientes), diferencia muy superior en mujeres que en hombres, y mayor frecuencia de dolor oral. El edentulismo y el menor número de dientes se asociaron a mayor probabilidad de sospecha de deterioro cognitivo, asociaciones que no se mantuvieron en modelos ajustados. El dolor oral se asoció a mayor probabilidad de sospecha de deterioro cognitivo (odds ratio: 1,99; intervalo de confianza del 95% [IC95%]: 1,09-3,63). Por cada diente adicional se observó un aumento del 2% (IC95%: 0,01-0,05) en la puntuación del MMSE. Conclusiones: La mala salud oral, en particular la pérdida de dientes y la presencia de dolor, se asociaron con deterioro cognitivo en personas mayores chilenas. (AU)

Objective: To identify the association between oral health and suspected cognitive impairment in older adults in Chile. Method: Cross-sectional study including 1826 people ≥60 years who participated in the National Health Survey of Chile, 2016-2017. Oral health was evaluated by the number of teeth, presence of caries, use of dental prostheses, self-reported oral health, and pain and/or discomfort in the oral cavity. Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). The association was evaluated by logistic and linear regression, adjusted for sociodemographic and lifestyle variables. Results: Compared with people without suspicion of cognitive impairment, people with suspected impairment had five fewer teeth (13.4 vs. 8.5 teeth), a much higher difference in women than in men, and a higher frequency of oral pain. Edentulism and fewer teeth were associated with a higher likelihood of suspected cognitive impairment, associations that were not maintained in adjusted models. Oral pain was associated with a higher likelihood of suspected impairment even in the most adjusted model (odds ratio: 1.99; 95% confidence interval [95%CI]: 1.09-3.63). In linear models, an increase of 2% (95%CI: 0.01-0.05) in the MMSE score was observed for each additional tooth. Conclusions: Poor oral health, particularly tooth loss and the presence of pain, was associated with cognitive impairment in older adults in Chile. (AU)

[ABSI obesity index and its association with type 2 diabetes mellitus in Chilean adults: a cross-sectional study of the ENS 2016-2017]. / Índice de obesidad ABSI y su asociación con diabetes mellitus tipo 2 en adultos chilenos: un estudio transversal de la ENS 2016-2017.

INTRODUCTION: A Body Shape Index (ABSI) is a new obesity index based on body volume; this has been associated with chronic non-communicable diseases and mortality, independent of the values of the body mass index (BMI); however, its association with type 2 diabetes mellitus (T2DM) in the Chilean adult population is unknown. OBJECTIVE: To determine the association between ABSI, glycemia, glycosylated hemoglobin (HbAc1), and self-reported T2DM in the Chilean adult population. MATERIALS AND METHODS: In a cross-sectional study, 4,874 participants were included (mean age 43.3 years, 50.9% women) from the 2016-2017 National Health Survey. ABSI was calculated according to the proposed formula (based on waist circumference, BMI, and height). The Poisson regression was used to investigate the association between ABSI and T2DM, and linear regression was used to investigate the association between ABSI, glycemia, and HbAc1. Sociodemographic factors, lifestyle, and BMI adjusted the analyses. RESULTS: ABSI was positively associated with glycemia (p < 0.001), HbA1c (p < 0.001), and DMT2 (p < 0.001). In the most adjusted model, for every 0.025 unit increase in ABSI, glycemia increased by 1.78 mg/dL (95% CI: 1.21, 2.35) and HbAc1 by 0.92% (95% CI: 0.49, 1.35). Regarding T2DM, the prevalence ratio was 1.14 (95% CI: 1.09, 1.20), independent of sociodemographic factors, lifestyles, and BMI. CONCLUSIONS: ABSI was linearly associated with a higher probability of suffering from T2DM and higher levels of glycemia and HbA1c in Chilean adults. In this context, ABSI could be a complementary index, independent of BMI, to assess the risk of metabolic disorders associated with obesity.

[Effect of Sedentary behaviors on the Interaction Between the FTO Gene and Adiposity Levels in Chilean Adults - Results from the GENADIO Study]. / Efecto del sedentarismo sobre la interacción entre el gen FTO y niveles de adiposidad en adultos chilenos - Resultados del Estudio GENADIO.

BACKGROUND: The Fat-mass and obesity-associated-gene (FTO gene) and sedentary behavior time are associated with obesity. However, whether sedentary behavior time can modify the genetic predisposition to obesity in the Chilean population is unknown. Therefore, this study investigated the association between sedentary behavior, adiposity markers, and the FTO gene. METHODS: This cross-sectional study included 409 participants from the Genes, Environment, Diabetes, and Obesity (GENADIO) study. Adiposity markers studied included body weight, body mass index (BMI), waist circumference (WC), and fat mass. Sedentary behaviors were measured using accelerometers. Using multiple regression, we evaluated the interaction between sedentary behaviors and the FTO gene (rs9939609) on adiposity markers. RESULTS: Sedentary behaviors and the FTO genotype were positively associated with higher body weight, BMI, WC, and fat mass. However, the association between time of sedentary behavior and adiposity markers was higher in carriers of the risk variant for the FTO gene. For each hour of increment in sedentary behaviors, body weight increases by 1.36 kg ([95% CI: 0.27; 2.46], p = 0.015) and 2.95 kg ([95%CI: 1.24; 4.65], p = 0.001) in non-risk carriers (TT) versus risk carriers (AA), respectively. We observed similar results for WC, BMI, and body fat, but the interaction was significant only for WC. CONCLUSION: The association between sedentary behaviors and adiposity markers, especially body weight and WC, is higher in individuals who carry the risk variant of the FTO gene.

[Prevalence of frailty in the different regions of Chile: A cross-sectional analysis of the National Health Survey 2016-2017]. / Prevalencia de fragilidad en las distintas regiones de Chile: Un análisis transversal de la Encuesta Nacional de Salud 2016-2017.

Frailty is an increasingly frequent geriatric syndrome in the population; however, its regional prevalence in Chile has not been quantified. AIM: To determine the prevalence of frailty according to Chile's regions, using the Frailty Index (IF). MATERIAL AND METHODS: In this cross-sectional study, data from 3,036 participants with 40 or more years of the National Health Survey 2016-17 were used. For the measurement of frailty, we created a 49-item IF, and everyone was given a score from 0 to 1. Based on the score obtained, we categorized the participants as: «robust¼, «pre-frail¼, and «frail¼. The prevalence was calculated and divided according to geographical areas (North, Center, and South), considering the 15 regions of Chile in force as of 2016. RESULTS: At the national level, the prevalence of robust, pre-frail, and frail individuals was 47,6%, 40,6%, and 11,8%, respectively. 15,9% were women and 7,4% men; 18,9% of the sample had less than eight years of education. The Libertador General Bernardo OHiggins Region showed a higher prevalence of frailty (18,3%), followed by the Maule Region (16,7%), which also had a higher prevalence of pre-frailty (49,6%). The Tarapacá Region presented a higher prevalence of robust people (64,6%). CONCLUSIONS: The prevalence off rail individuals was higher in the central zone of Chile, it increased as age increased, and it was higher in women with a lower educational level.

[Association between low vitamin D levels and cognitive impairment in Chilean older adults: findings of the National Health Survey 2016-2017]. / Asociación entre bajos niveles de vitamina D y deterioro cognitivo en personas mayores chilenas: Resultados de la Encuesta Nacional de Salud 2016-2017.

INTRODUCTION: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. MATERIAL AND METHOD: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. RESULTS: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. CONCLUSION: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Walking pace could be considered an early risk marker of cognitive impairment in older people. Objective: To determine the association between walking pace and cognitive impairment in older Chilean adults. Methods: 1,788 adults older than 60 years from the 2016-2017 Chilean National Health Survey with data available in the exposure and outcome were included in this cross-sectional study. Walking pace was self-reported and categorised as slow, average and brisk. Cognitive impairment was assessed using the Abbreviated Mini-Mental questionnaire. Logistic regression analyses were performed to investigate the association between walking pace and cognitive impairment, logistic regression analyses - adjusted for sociodemographic, lifestyle and health-related covariates. Results: In the minimally adjusted model and compared to older adults who self-reported a brisk walking pace, those in the slow walking pace category were 2.67 times more likely to have cognitive impairment (OR: 2.67 [95% CI: 1.62, 4.42]). When the analyses were adjusted, the association was attenuated but remained significant (OR: 1.78 [95% CI: 1.15 3.17]). No associations were found between average pace walkers and cognitive impairment. Conclusion: Older adults who self-reported a slow walking pace having a higher likelihood of cognitive impairment than their counterparts who had a brisk walking pace. Considering that cognitive impairment is a geriatric syndrome with a high prevalence in the elderly, there is a need to emphasise strategies for an early diagnosis. Therefore, walking pace may be a useful marker to identify individuals at high risk of cognitive impairment.