Estrategias para un envejecimiento exitoso / Strategies for successful ageing

En los últimos años ha habido un aumento en el interés por la medicina antienvejecimiento con un crecimiento de la industria de productos que prometen prolongar la vida y restaurar todo padecimiento o «defecto» producido por la edad. El entendimiento del envejecimiento ha evolucionado, dando cabida a la posibilidad de intervenir en diferentes vías metabólicas y celulares y así, retrasar la aparición de las enfermedades crónicas degenerativas que aparecen con la edad y que finalmente son las causantes de la vulnerabilidad que nos lleva a la muerte. Esperamos poder ayudar al clínico a orientar a sus pacientes, quienes ante la información abrumadora que reciben por Internet, acuden al consultorio llenos de preguntas, esperando recibir del médico la respuesta absoluta para aumentar su longevidad y calidad de vida. Este artículo analiza la actividad física, las dietas, los suplementos y fármacos que se están explorando como medidas antienvejecimiento y de los que múltiples estudios clínicos han arrojado resultados alentadores medibles y reproducibles (AU)

There has been an increase in the interest of anti-ageing medicine in the last few years, with a growth in the industry of products that promise to prolong life and restore all the suffering or «defects» produced by age. The understanding of ageing has changed over the years, giving rise to the possibility of intervening in different metabolic and cellular pathways, and thus, delaying the appearance of the degenerative chronic diseases that appear with age, and that are finally the causing factors of the vulnerability that leads to our death. It is hoped that we can help the clinician to orientate their patients, who, due to the overwhelming amount of information they receive by the Internet, arrive at the clinic full of questions, waiting to receive absolute answer from their physician in order to increase their longevity and quality of life. This article presents an analysis of the physical activity, diets, supplements and drugs that are being investigated as anti-ageing measures and of the many clinical studies that have produced encouraging, measurable and reproducible results (AU)

[Strategies for successful ageing]. / Estrategias para un envejecimiento exitoso.

There has been an increase in the interest of anti-ageing medicine in the last few years, with a growth in the industry of products that promise to prolong life and restore all the suffering or "defects" produced by age. The understanding of ageing has changed over the years, giving rise to the possibility of intervening in different metabolic and cellular pathways, and thus, delaying the appearance of the degenerative chronic diseases that appear with age, and that are finally the causing factors of the vulnerability that leads to our death. It is hoped that we can help the clinician to orientate their patients, who, due to the overwhelming amount of information they receive by the Internet, arrive at the clinic full of questions, waiting to receive absolute answer from their physician in order to increase their longevity and quality of life. This article presents an analysis of the physical activity, diets, supplements and drugs that are being investigated as anti-ageing measures and of the many clinical studies that have produced encouraging, measurable and reproducible results.

Prevalencia de patología del pie en una población geriátrica y su impacto en la función, la marcha y el síndrome de caídas / Prevalence of foot conditions in a geriatric population and their impact on mobility, gait and tendency to falls

Introducción. La patología del pie es común en la población geriátrica. Se conoce poco sobre su prevalencia y el impacto que tiene sobre la función, la marcha y las caídas. Material y métodos. Se realizó una valoración geriátrica a 171 mujeres institucionalizadas. Se tomaron fotografías del pie que fueron valoradas por un ortopedista y una dermatóloga. Se realizó análisis multivariado para estimar el efecto de las variables independientes sobre función, marcha y síndrome de caídas. Resultados. Las alteraciones del pie más encontradas fueron la presencia de dedos en garra (122), callos (79) e insuficiencia vascular periférica (74). El hallux rígido (OR 24,897, IC del 95%, 1.231-503.542) y la insuficiencia vascular periférica (OR 2.481, IC del 95%, 1.095-5.623) se relacionaron con alteración en la marcha; ambas se asociaron a dependencia a las actividades instrumentales de la vida diaria (OR 44.166, IC del 95%, 2.402-812.233, y OR 2.659, IC del 95%, 1.069-6.615). El hallux rígido se asoció a caídas (OR 19.27, IC del 95%, 1.102-337.26). La tiña se relacionó con dependencia en las actividades de la vida diaria (OR 11.52, IC del 95%, 1.325-100.125). Conclusiones. La patología del pie es muy común en la población geriátrica. Únicamente el hallux rígido y la insuficiencia vascular periférica impactaron en la función y la marcha(AU)

Introduction. Foot disease is common among the elderly. Little is known about its prevalence and impact over mobility, gait and tendency to fall. Material and methods. A geriatric history was taken from 171 women living in a long-term care facility. Photographs were taken of the feet and evaluated by an orthopaedic surgeon and a dermatologist. A multivariate analysis was made to assess de effect of the independent variables over mobility, gait and tendency to fall. Results. The foot diseases most commonly found were hammer toes (122), callus (79) and peripheral vascular disease (74). Hallux rigidus (OR 24.897, 95% CI, 1.231-503.542) and peripheral vascular disease (OR 2.481, 95% CI, 1.095-5.623) seemed to be associated with changes in gait; both where associated with dependency on instrumental activities of daily living (OR 44.166, 95% CI, 2.402-812.233, and OR 2.659, 95% CI, 1.069-6.615). Hallux rigidus was related to falls (OR 19.27, 95% CI, 1.102-337.26). Tinea pedis was associated with dependency in activities of daily living (OR 11.52, 95% CI, 1.325-100.125). Conclusions. Foot disorders are common in the elderly. Only hallux rigidus and peripheral vascular disease had an impact on function and gait(AU)

[Prevalence of foot conditions in a geriatric population and their impact on mobility, gait and tendency to falls]. / Prevalencia de patología del pie en una población geriátrica y su impacto en la función, la marcha y el síndrome de caídas.

INTRODUCTION: Foot disease is common among the elderly. Little is known about its prevalence and impact over mobility, gait and tendency to fall. MATERIAL AND METHODS: A geriatric history was taken from 171 women living in a long-term care facility. Photographs were taken of the feet and evaluated by an orthopaedic surgeon and a dermatologist. A multivariate analysis was made to assess de effect of the independent variables over mobility, gait and tendency to fall. RESULTS: The foot diseases most commonly found were hammer toes (122), callus (79) and peripheral vascular disease (74). Hallux rigidus (OR 24.897, 95% CI, 1.231-503.542) and peripheral vascular disease (OR 2.481, 95% CI, 1.095-5.623) seemed to be associated with changes in gait; both where associated with dependency on instrumental activities of daily living (OR 44.166, 95% CI, 2.402-812.233, and OR 2.659, 95% CI, 1.069-6.615). Hallux rigidus was related to falls (OR 19.27, 95% CI, 1.102-337.26). Tinea pedis was associated with dependency in activities of daily living (OR 11.52, 95% CI, 1.325-100.125). CONCLUSIONS: Foot disorders are common in the elderly. Only hallux rigidus and peripheral vascular disease had an impact on function and gait.

Prevalencia de síndromes geriátricos en el 2010 en ancianos hospitalizados en el ABC Medical Center IAPEs / Prevalence of geriatric syndrome among elderly patients attended in ABC Medical Center, 2010

Objetivos: determinar la prevalencia de síndromes geriátricos en ancianos de 80 años o mayores en el ABC Medical Center IAP y compararla con la encontrada 5 años antes. Relacionar ambas con la reportada en la literatura geriátrica. Pacientes y métodos: estudio retrospectivo, descriptivo, transversal de personas adultas mayores de 80 años y que ingresaron al ABC Medical Center IAP durante el periodo de marzo 2009 a julio 2010, a quienes se les realizó una valoración geriátrica completa. Resultados: se incluyó a 369 pacientes, con edad media de 84.49 ± 4.4 años, de ellos 216 eran mujeres (58.5%). La valoración permitía identificar 23 síndromes geriátricos, el más frecuente fue el de polifarmacia, con prevalencia del 56.91%, y el menos frecuente fue abuso-maltrato, con 0%. Comparativamente con lo encontrado hace 5 años, se encontró que la mayoría de los síndromes disminuyeron; sin embargo, caídas, inmovilidad, trastornos de la marcha, deterioro cognitivo, desnutrición, obesidad, déficit visual, auditivo, colapso del cuidador y abuso/maltrato tuvieron una prevalencia similar. La depresión y el déficit auditivo mantuvieron rangos similares a los reportados en la literatura médica. Conclusiones: la prevalencia de los síndromes geriátricos en nuestra población está determinada por el nivel socioeconómico y por la edad (viejos-viejos). El conocimiento de los principales síndromes geriátricos reportados permite implementar acciones específicas que disminuyan su presentación, por medio de programas de educación e información dirigidos tanto a médicos y personal paramédico, como a familiares y los propios pacientes.

Objective: To determine the prevalence of geriatric syndromes in elderly patients over 80 years of age in the ABC Medical Center IAP, a Private Institution, and compare it with that found five years earlier, and compare both with the one reported in the literature. Patients and methods: A retrospective, descriptive, cross-sectional study of adults over 80 years of age admitted to the ABC Medical Center IAP from March 2009 to July 2010, who underwent a comprehensive geriatric assessment. Results: 369 patients were included, mean age 84.49 ± 4.4, 216 were women (58.5%). The assessment allowed the identification of 23 geriatric syndromes; the most frequent was polypharmacy with a prevalence of 56.91% and the less frequent was abuse with a prevalence of 0%. Most syndromes decreased, compared to 5 years ago. However, the prevalence of some geriatric syndromes like falls, immobility, gait disturbance, cognitive impairment, malnutrition, obesity, poor vision, hearing, caregiver collapse, and abuse/ ill-treatment were similar to those reported five years ago. Depression and hearing loss maintained similar levels as those reported in medical literature. Conclusions: The prevalence of geriatric syndromes in our population is determined by the socioeconomic level and by age itself (old-old). Knowledge of the main geriatric syndromes allows the implementation of specific actions to reduce their occurrence, through educational and informative programs addressed to health professionals, families and the very patient.

[Urinary incontinence in the elderly]. / Incontinencia urinaria en el adulto mayor.

Urinary Incontinence (UI) is a cardinal geriatric syndrome that has an impact on the health and quality of life of the elderly and those living around them. The etiology is often multifactorial. Physical, cognitive, functional, and psychological factors contribute to the appearance of UI. In most patients, the clinical history and a good physical examination are enough to diagnose UI accurately; although to confirm and classify UI further more complex tests are needed. The fields of pharmacology, endoscopy, neurophysiology, and surgery are making significant progress to manage UI; therefore, is useful for all practicing physicians that attend elderly patients to learn about the new therapeutic options.