Evaluación de pruebas psicoacústicas y de potenciales relacionados a eventos P300 en adultos mayores con hiperhomocisteinemia / Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia

Introducción y objetivos: La hiperhomocisteinemia como un factor de riesgo para el daño auditivo, el daño neuronal y el deterioro cognitivo en los pacientes adultos mayores es controvertido y se encuentra limitado por un pequeño número de estudios. El objetivo de este trabajo es determinar si los pacientes adultos mayores con hiperhomocisteinemia presentan mayor riesgo de desarrollar alteraciones en los procesos centrales de la audición frente a un grupo de pacientes con niveles de homocisteína adecuados, y definir el comportamiento de las pruebas psicoacústicas y de potenciales de latencia larga (P300) en estos grupos. Método: Estudio transversal, comparativo y analítico. Se formó un grupo de pacientes con hiperhomocisteinemia y un grupo control con valores normales de homocisteína. A todos los pacientes se les realizó audiometría tonal, impedanciometría y una selección de pruebas psicoacústicas (dígitos dicóticos, palabras filtradas pasa bajo, palabra en ruido y diferencia en niveles de enmascaramiento), así como potenciales evocados auditivos de tallo cerebral y P300. Resultados: Los pacientes con hiperhomocisteinemia presentaron valores en la prueba de diferencia en los niveles de enmascaramiento superiores a los del grupo control (p = 0,049), así como latencias más prologadas en los P300 (p = 0,000). Conclusiones: La hiperhomocisteinemia es un factor que altera las funciones auditivas centrales. Las pruebas psicoacústicas alteradas junto con la alteración en las pruebas electrofisiológicas sugieren que la porción central de la vía auditiva está afectada en los pacientes con hiperhomocisteinemia (AU)

Introduction and objectives: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. Methods: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Results: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=0.049) and more protracted latency in P300 (P=0.000). Conclusions: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia (AU)

Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia.

INTRODUCTION AND OBJECTIVES: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. METHODS: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. RESULTS: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). CONCLUSIONS: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia.

[Evaluation of the primary caregiver syndrome when caring for elderly adults with immobility syndrome]. / Evaluación del colapso del cuidador primario de pacientes adultos mayores con síndrome de inmovilidad.

INTRODUCTION: Caregiver syndrome may develop in caregivers of elderly adults. OBJECTIVE: To evaluate the repercussions of the immobility syndrome present in elderly adults on their primary caregivers as well as to determine the clinical and socio-demographic characteristics of the elderly adult and caregiver. MATERIAL AND METHODS: The study population included patients over 65 recruited in the Geriatric Rehabilitation Department, with the diagnosis of immobility syndrome and that required a primary caregiver. A questionnaire including socio-demographic variables was applied to all patients and caregivers, and the Zarit scale was also applied to caregivers in order to determine the presence of caregiver syndrome. Analysis was performed with descriptive statistical methods; Student's t test and Fisher's test were used for comparisons between strata. RESULTS: 75 patients and their caregivers were evaluated; patient average age was 75.9 years and 85.3% were female. 50.7% (38 cases) had mild immobility. The average caregiver's age was 50.6%, 70.7% were female and 57.3% were the patient's daughter. Caregiver syndrome was detected in 60% of them: 57.7% had mild symptoms and in 42.2%, symptoms were moderate to severe. No statistically significant association was established between the development of caregiver syndrome and the degree of patient immobility. CONCLUSIONS: Caregivers of patients with immobility syndrome are at high risk of developing caregiver syndrome, thus underscoring the need to include primary caregiver support programs.