Situación actual de la investigación sobre las condiciones de vida y el estado de salud de las personas mayores en España / Current situation of the research on living conditions and health status of elderly people in Spain

OBJETIVO: Analizar las dimensiones estudiadas en la investigación sobre las condiciones de vida y salud de las personas mayores no institucionalizadas en la literatura científica en el medio español. MÉTODO: Análisis de contenidos basado en fuentes secundarias, realizado mediante búsquedas bibliográficas de documentos en Pubmed y Embase en castellano y en inglés. La estrategia de búsqueda combinó términos o categorías relacionados con personas mayores, condiciones de vida y/o salud y España. Se incluyeron los estudios que evaluasen condiciones de vida y/o salud de las personas mayores en España. Se excluyeron los que analizaban un aspecto concreto de las condiciones de vida o salud y los que incluían o se centraban en la población institucionalizada. RESULTADOS: Para el análisis de contenidos se consideró un total de 14 estudios y/o informes como relevantes. Los trabajos localizados son habitualmente de ámbito local, de tipo transversal y la recogida de datos se realiza mediante entrevista al individuo. Se observó variabilidad en los aspectos analizados sobre las condiciones de vida y salud de las personas mayores. La valoración de las características sociodemográficas, el estado de salud y los hábitos de vida se estudiaron de forma habitual. Los aspectos relacionados con el estado del entorno de la vivienda fueron escasamente analizados. CONCLUSIONES: Este estudio permite conocer las dimensiones priorizadas en los estudios sobre condiciones de vida y salud realizados hasta el momento actual en el medio español. Además, aporta claves para el desarrollo de investigaciones futuras que articulen de manera integrada las condiciones de vida y el estado de salud de las personas mayores, aspectos estrechamente relacionados

OBJECTIVE: To analyse the dimensions studied with respect to living and health conditions of the non-institutionalised elderly in the scientific literature in Spain. Method: A content analysis based on secondary sources was carried out by literature searches in Pubmed and Embase in Spanish and English. The search strategies combined terms related to older people, health and/or living conditions and with Spain. All studies assessing living and/or health conditions of elderly in Spain were included. Studies analyzing a specific aspect of living or health conditions and those based on institutionalized population were excluded. RESULTS: A total of 14 studies were considered in the content analysis. The studies are usually local, cross-sectional and data collection is done by direct interview. Variability was observed in the aspects analysed about living and health conditions. All studies included: sociodemographic characteristics, health status and lifestyle habits. Issues related to the status of the out-of home environment are poorly analysed. CONCLUSIONS: This work allows knowing the dimensions prioritised in the studies carried out to date about health and living conditions in Spain. It also provides key elements for the development of future research aiming to integrate both living and health conditions of elderly population, both aspects closely related

[Current situation of the research on living conditions and health status of elderly people in Spain]. / Situación actual de la investigación sobre las condiciones de vida y el estado de salud de las personas mayores en España.

OBJECTIVE: To analyse the dimensions studied with respect to living and health conditions of the non-institutionalised elderly in the scientific literature in Spain. METHOD: A content analysis based on secondary sources was carried out by literature searches in Pubmed and Embase in Spanish and English. The search strategies combined terms related to older people, health and/or living conditions and with Spain. All studies assessing living and/or health conditions of elderly in Spain were included. Studies analyzing a specific aspect of living or health conditions and those based on institutionalized population were excluded. RESULTS: A total of 14 studies were considered in the content analysis. The studies are usually local, cross-sectional and data collection is done by direct interview. Variability was observed in the aspects analysed about living and health conditions. All studies included: sociodemographic characteristics, health status and lifestyle habits. Issues related to the status of the out-of home environment are poorly analysed. CONCLUSIONS: This work allows knowing the dimensions prioritised in the studies carried out to date about health and living conditions in Spain. It also provides key elements for the development of future research aiming to integrate both living and health conditions of elderly population, both aspects closely related.

Multimorbidity Patterns in Hospitalized Older Patients: Associations among Chronic Diseases and Geriatric Syndromes.

BACKGROUND/OBJECTIVES: The clinical status of older individuals with multimorbidity can be further complicated by concomitant geriatric syndromes. This study explores multimorbidity patterns, encompassing both chronic diseases and geriatric syndromes, in geriatric patients attended in an acute hospital setting. DESIGN: Retrospective observational study. SETTING: Unit of Social and Clinical Assessment (UVSS), Miguel Servet University Hospital (HUMS), Zaragoza (Spain). Year, 2011. PARTICIPANTS: A total of 924 hospitalized patients aged 65 years or older. MEASUREMENTS: Data on patients' clinical, functional, cognitive and social statuses were gathered through comprehensive geriatric assessments. To identify diseases and/or geriatric syndromes that cluster into patterns, an exploratory factor analysis was applied, stratifying by sex. The factors can be interpreted as multimorbidity patterns, i.e., diseases non-randomly associated with each other within the study population. The resulting patterns were clinically assessed by several physicians. RESULTS: The mean age of the study population was 82.1 years (SD 7.2). Multimorbidity burden was lower in men under 80 years, but increased in those over 80. Immobility, urinary incontinence, hypertension, falls, dementia, cognitive decline, diabetes and arrhythmia were among the 10 most frequent health problems in both sexes, with prevalence rates above 20%. Four multimorbidity patterns were identified that were present in both sexes: Cardiovascular, Induced Dependency, Falls and Osteoarticular. The number of conditions comprising these patterns was similar in men and women. CONCLUSION: The existence of specific multimorbidity patterns in geriatric patients, such as the Induced Dependency and Falls patterns, may facilitate the early detection of vulnerability to stressors, thus helping to avoid negative health outcomes such as functional disability.

Oral anticoagulation and self-management: analysis of the factors that determine the feasibility of using self-testing and self-management in primary care.

BACKGROUND: The skills of patients on oral anticoagulants are critical for achieving good outcomes with this treatment. Self-management, or the capacity of patients to control their INR level and adjust their treatment, is an effective strategy of treatment. Capacity of patients to self manage is determined by a range of factors. The identification of these factors would improve the design of self management programmes and in turn increase the number of patients able to self-manage. The objective of our study is to identify those factors that determine the ability of patients on oral anticoagulant therapy to achieve self-management of their treatment. DESIGN: This will be a three year quasi- experimental prospective study with a control group. 333 patients on anticoagulant therapy from five health centres of the Basque Health Service are to be followed up for a period of six months each after the intervention, to assess their ability to self-test and self-manage. The intervention will consist of a patient training programme involving the provision of information and practical training concerning their condition and its treatment, as well as how to use a portable blood coagulation monitoring device and adjust their anticoagulant dose. DISCUSSION: The ease-of-use of this technique lead us to believe that self-management is feasible and will represent an innovative advance that should have a substantial impact on the quality of life of this patients and their families as well as on the health care provision systems. TRIAL REGISTRATION: Osakidetza Protocol Record ISCIII-11/02285, Oral anticoagulation and self-management, ClinicalTrials.gov Identifier: NCT01878539.