Characterization in end-of-life care of older people attended by geriatricians / Caracterización de la atención al final de la vida de personas mayores atendidas por geriatría

Background and objective Symptom control at the end of life is essential, and palliative sedation is a viable intervention option for the care of terminally ill patients. This study aims to characterize the elderly population receiving end-of-life care plans and their management with palliative sedation in a geriatric unit at a high complexity hospital. Materials and methods A cross-sectional study was conducted, and a descriptive analysis was performed. Medical records of 163 patients admitted to a high complexity hospital in Bogota, Colombia between January 2016 and December 2019 were reviewed. Results From 163, 141 patients received an end-of-life care plan, and 22 were managed with palliative sedation. The mean age was 84 years, the most frequent cause of death was respiratory infections and 44% of patients had a history of cancer. Prior to admission, functional decline and the presence of moderate to severe dementia were frequently found. About one in ten persons required palliative sedation, which lasted an average of 2.22±5 days. The most common refractory symptom was dyspnea (45.45%), followed by pain (36.36%). Conclusions Palliative sedation is prevalent in the elderly population and characterizing this population can provide increased knowledge to improve end-of-life care (AU)

Antecedentes y objetivos El control de síntomas al final de la vida es fundamental, y la sedación paliativa resulta una opción de intervención en el cuidado de pacientes con enfermedades terminales. El objetivo es caracterizar una población de personas mayores que recibieron un plan de atención del final de la vida, incluyendo sedación paliativa en una unidad de geriatría de un hospital de alta complejidad. Materiales y métodos Estudio de corte transversal, se realizaron análisis descriptivos y se utilizaron métodos de acuerdo con el tipo de variable. Se revisaron las historias clínicas de 163 pacientes entre enero de 2016 y diciembre de 2019 de un hospital de alta complejidad en Bogotá, Colombia. Resultados Sobre 163 pacientes, 141 recibieron plan de atención de final de vida y 22 fueron manejados con sedación paliativa. La edad promedio fue de 84 años y el 58% eran mujeres. La causa de muerte más frecuente fue respiratoria infecciosa; el 44% tenían antecedente oncológico. La declinación funcional previa al ingreso y la presencia de demencia moderada o severa fueron condiciones que frecuentemente se encontraron en quienes se reorientó el esfuerzo terapéutico. Una de cada 10 personas requirió sedación paliativa, cuya duración fue de 2,22±5 días, el síntoma refractario más frecuente fue la disnea (45,45%), seguido de dolor (36,36%). Conclusiones La sedación paliativa resulta frecuente en la población mayor con enfermedades no oncológicas. La caracterización de estas personas promueve el aumento del conocimiento y la preparación para mejorar el manejo del final de la vida (AU)

Characterization in end-of-life care of older people attended by geriatricians.

BACKGROUND AND OBJECTIVE: Symptom control at the end of life is essential, and palliative sedation is a viable intervention option for the care of terminally ill patients. This study aims to characterize the elderly population receiving end-of-life care plans and their management with palliative sedation in a geriatric unit at a high complexity hospital. MATERIALS AND METHODS: A cross-sectional study was conducted, and a descriptive analysis was performed. Medical records of 163 patients admitted to a high complexity hospital in Bogota, Colombia between January 2016 and December 2019 were reviewed. RESULTS: From 163, 141 patients received an end-of-life care plan, and 22 were managed with palliative sedation. The mean age was 84 years, the most frequent cause of death was respiratory infections and 44% of patients had a history of cancer. Prior to admission, functional decline and the presence of moderate to severe dementia were frequently found. About one in ten persons required palliative sedation, which lasted an average of 2.22±5 days. The most common refractory symptom was dyspnea (45.45%), followed by pain (36.36%). CONCLUSIONS: Palliative sedation is prevalent in the elderly population and characterizing this population can provide increased knowledge to improve end-of-life care.

[Bringing back sounds: prevention of hearing loss and auditory rehabilitation in the elderlyRecuperando os sons: prevenção da perda auditiva e reabilitação auditiva em pessoas idosas]. / Retomando los sonidos: Prevención de la hipoacusia y rehabilitación auditiva en las personas mayores.

Hearing loss is one of the leading causes of disability worldwide and its prevalence increases with age, though in most cases, this disability is potentially preventable and treatable. Thus, its prevention, early identification, and comprehensive rehabilitation should be points of action at the local level, since hearing loss has been linked to numerous adverse health outcomes affecting the physical, mental, social, and economic conditions of older people. The objective of this article is to highlight the importance of hearing loss prevention, promote rehabilitation throughout the life course, especially in older people, and describe strategies put forth by the World Health Organization and Pan American Health Organization.

A perda auditiva representa uma das principais causas de incapacidade em todo o mundo e sua prevalência aumenta com a idade. Representa um tipo de deficiência que, na maioria dos casos, é potencialmente prevenível e tratável e, por essa razão, sua prevenção, identificação precoce e reabilitação integral devem ser alguns dos pontos de ação no âmbito local, considerando que está relacionada a inúmeros desfechos adversos de saúde, incluindo os domínios físico, mental, social e econômico das pessoas idosas. O objetivo deste artigo é ressaltar a importância da prevenção da perda auditiva e de sua reabilitação ao longo da vida, especialmente nas pessoas idosas, e descrever estratégias propostas pela Organização Mundial da Saúde e pela Organização Pan-Americana da Saúde.

Retomando los sonidos: Prevención de la hipoacusia y rehabilitación auditiva en las personas mayores

[RESUMEN]. La hipoacusia representa una de las principales causas de discapacidad a nivel mundial y su prevalencia aumenta a medida que se envejece. Representa un tipo de discapacidad que, en la mayoría de los casos, puede ser potencialmente prevenible y tratable, por lo que su prevención, identificación temprana y rehabilitación integral deberían ser algunos de los puntos de acción a nivel local ya que se ha relacionado con numerosos desenlaces adversos en salud, incluyendo los dominios físico, mental, social y económico de las personas mayores. El objetivo de este artículo es resaltar la importancia de la prevención de la hipoacusia y promover su rehabilitación a lo largo del curso de vida, especialmente en personas mayores, y describir estrategias que se han planteado desde la Organización Mundial de la Salud y la Organización Panamericana de la Salud.

[ABSTRACT]. Hearing loss is one of the leading causes of disability worldwide and its prevalence increases with age, though in most cases, this disability is potentially preventable and treatable. Thus, its prevention, early identification, and comprehensive rehabilitation should be points of action at the local level, since hearing loss has been linked to numerous adverse health outcomes affecting the physical, mental, social, and economic conditions of older people. The objective of this article is to highlight the importance of hearing loss prevention, promote rehabilitation throughout the life course, especially in older people, and describe strategies put forth by the World Health Organization and Pan American Health Organization.

[RESUMO]. A perda auditiva representa uma das principais causas de incapacidade em todo o mundo e sua prevalência aumenta com a idade. Representa um tipo de deficiência que, na maioria dos casos, é potencialmente prevenível e tratável e, por essa razão, sua prevenção, identificação precoce e reabilitação integral devem ser alguns dos pontos de ação no âmbito local, considerando que está relacionada a inúmeros desfechos adversos de saúde, incluindo os domínios físico, mental, social e econômico das pessoas idosas. O objetivo deste artigo é ressaltar a importância da prevenção da perda auditiva e de sua reabilitação ao longo da vida, especialmente nas pessoas idosas, e descrever estratégias propostas pela Organização Mundial da Saúde e pela Organização Pan-Americana da Saúde.

Cambios en la marcha asociados con demencia por cuerpos de Lewy: una revisión narrativa de la literatura / Gait changes associated with Lewy body dementia: a narrative review of the literature

RESUMEN INTRODUCCIÓN: La demencia por cuerpos de Lewy (DCL) es una enfermedad neurodegenerativa con alta prevalencia y a menudo subdiagnosticada. En las demencias pueden presentarse alteraciones en la marcha que potencialmente permitan identificar su subtipo y dar una orientación clínica, diagnóstica y terapéutica temprana. Esta revisión narrativa de la literatura busca revisar los cambios de la marcha que se han descrito asociados con DCL. MATERIALES Y MÉTODOS: Se realizó una revisión de la literatura sobre la relación de las alteraciones de la marcha con la DCL. Se seleccionaron los siguientes parámetros de búsqueda mediante el buscador Scopus: ((falls and dementia and gait and (evaluation or analysis))). Los datos se ordenaron según relevancia y se obtuvieron 267 resultados. Igualmente, se hizo una búsqueda en PubMed, para a la que se introdujeron los términos (gait and lewy-body-disease), y no se utilizaron otros filtros; se obtuvieron 139 resultados. Se hizo una selección no sistemática de los artículos para llevar a cabo una revisión narrativa acerca de los cambios en la marcha asociados con DCL. RESULTADOS: Las alteraciones en la marcha pueden tener un valor predictor importante en la DCL. Los pacientes con demencias no debido a EA o causas vasculares muestran un deterioro de la funcionalidad física más rápido comparado con pacientes con EA y sin problemas cognitivos. La priorización incorrecta de las tareas, evidenciada en la EP, también es observable en los pacientes con DCL, y se asocia con el paradigma de doble tarea en el paciente con trastorno neurocognitivo mayor. El congelamiento de la marcha, también conocido como bloqueo de la marcha, se ha asociado con mayor progresión de la alteración cognitiva. Los pacientes con DCL también presentan un mayor compromiso en el tiempo de balanceo y la variabilidad de duración de la zancada, como también peor desempeño en ritmo y variabilidad de la marcha, e inestabilidad de la marcha, con posturas inadecuadas. CONCLUSIONES: Existe una relación entre la DCL y las caídas en el adulto mayor. En este grupo de edad, los cambios en la marcha y en las pruebas de desempeño podrían tener una utilidad clínica como factores asociados a con DCL, así como con las caídas. Al parecer, existe una variación característica entre los parámetros de la marcha y los subtipos de demencias que puede tener un valor como marcador diagnóstico. Se requieren más estudios con respecto a este tema puesto que hay escasa evidencia disponible hasta el momento, lo cual impide definir con mayor precisión las alteraciones más sensibles de cada dominio de la marcha que permitan diferenciar el envejecimiento normal del patológico.

ABSTRACT INTRODUCTION: Lewy body dementia is a highly prevalent neurodegenerative disease and often goes unnoticed due to little knowledge about it. In dementias there may be gait alterations that potentially allow the identification of its subtype and provide early clinical, diagnostic, and therapeutic guidance. This narrative review of the literature aims to review gait changes that have been described as associated with Lewy body dementia. MATERIALS AND METHODS: A literature review was carried out on the relationship of gait disturbances and LBD. The following search parameters were selected using the Scopus search engine: ((falls and dementia and gait and (evaluation or analysis))). The data were ordered according to relevance, obtaining 267 results. Likewise, a search was made in PubMed, using the terms (gait and lewy-body-disease), and no other filters were used, obtaining 139 results. A non-systematic selection of literature was made to carry out a narrative review about the changes in gait associated with LBD. RESULTS: We found that gait disturbances may have an important predictive value in LBD. Patients with dementias not due to AD or vascular causes have a faster deterioration of physical function compared to patients with AD and without cognitive problems. The incorrect prioritization of tasks evidenced in PD is also observable in patients with LBD and is associated with the "dual-task" paradigm in patients with major neurocognitive disorder. Freezing of gait, also known as motor block or "freezing of gait" has been associated with a greater progression of cognitive impairment. Patients with LBD also show greater compromise in swing time, stride duration variability, poorer performance in gait pace and variability, and gait instability with inappropriate postures. CONCLUSIONS: We observe that there is a relationship between LBD and falls in the elderly. Changes in gait and performance tests could have clinical utility as factors associated with LBD as well as falls in the elderly. There appears to be a characteristic variation between gait parameters and dementia subtypes that may have value as a diagnostic marker. More studies are required on this subject since there is little evidence available to date, which makes it impossible to define with greater precision the most sensitive alterations in each domain of gait that make it possible to differentiate normal from pathological aging.

Retomando los sonidos: Prevención de la hipoacusia y rehabilitación auditiva en las personas mayores / Bringing back sounds: prevention of hearing loss and auditory rehabilitation in the elderly / Recuperando os sons: prevenção da perda auditiva e reabilitação auditiva em pessoas idosas

RESUMEN La hipoacusia representa una de las principales causas de discapacidad a nivel mundial y su prevalencia aumenta a medida que se envejece. Representa un tipo de discapacidad que, en la mayoría de los casos, puede ser potencialmente prevenible y tratable, por lo que su prevención, identificación temprana y rehabilitación integral deberían ser algunos de los puntos de acción a nivel local ya que se ha relacionado con numerosos desenlaces adversos en salud, incluyendo los dominios físico, mental, social y económico de las personas mayores. El objetivo de este artículo es resaltar la importancia de la prevención de la hipoacusia y promover su rehabilitación a lo largo del curso de vida, especialmente en personas mayores, y describir estrategias que se han planteado desde la Organización Mundial de la Salud y la Organización Panamericana de la Salud.

ABSTRACT Hearing loss is one of the leading causes of disability worldwide and its prevalence increases with age, though in most cases, this disability is potentially preventable and treatable. Thus, its prevention, early identification, and comprehensive rehabilitation should be points of action at the local level, since hearing loss has been linked to numerous adverse health outcomes affecting the physical, mental, social, and economic conditions of older people. The objective of this article is to highlight the importance of hearing loss prevention, promote rehabilitation throughout the life course, especially in older people, and describe strategies put forth by the World Health Organization and Pan American Health Organization.

RESUMO A perda auditiva representa uma das principais causas de incapacidade em todo o mundo e sua prevalência aumenta com a idade. Representa um tipo de deficiência que, na maioria dos casos, é potencialmente prevenível e tratável e, por essa razão, sua prevenção, identificação precoce e reabilitação integral devem ser alguns dos pontos de ação no âmbito local, considerando que está relacionada a inúmeros desfechos adversos de saúde, incluindo os domínios físico, mental, social e econômico das pessoas idosas. O objetivo deste artigo é ressaltar a importância da prevenção da perda auditiva e de sua reabilitação ao longo da vida, especialmente nas pessoas idosas, e descrever estratégias propostas pela Organização Mundial da Saúde e pela Organização Pan-Americana da Saúde.

Gastrostomía descompresiva en obstrucción gastrointestinal maligna: reporte de caso y revisión de la literatura / Decompressive gastrostomy in patients with malignant gastrointestinal obstruction. Case report and literature review

Resumen La gastrostomía descompresiva durante los últimos años ha surgido como una alternativa de manejo para la paliación de síntomas en personas con enfermedad oncológica terminal que desarrollan obstrucción intestinal sin indicación quirúrgica inicial y es refractaria al manejo médico. El objetivo es brindar calidad de vida a través de la restauración de la vía oral. Sus contraindicaciones han variado con el tiempo; sin embargo, han surgido nuevas técnicas que permiten ampliar el espectro de indicaciones de este procedimiento. Se ha descrito que permite apoyar el control de síntomas, el retorno de la persona a su lugar de cuidado y, posiblemente, el reinicio de la vía oral con la intención de mantener la calidad de vida de la persona.

Abstract In recent years, decompressive gastrostomy has emerged as a therapeutic option for people with terminal cancer who experience intestinal obstruction without an initial surgical indication and refractory to medical treatment. The objective is to provide a better quality of life by restoring the oral route. Its contraindications have varied over time; however, new techniques have allowed broadening the spectrum of indications for this procedure. It has been reported that this technique supports symptom control and allows the return of the patients to their place of care. It could also allow restarting the oral route in order to maintain quality of life.

Efficacy and safety of sensor augmented insulin pump therapy with low-glucose suspend feature in older adults: A retrospective study in Bogota, Colombia.

BACKGROUND AND AIMS: The literature has supported the efficacy and safety of insulin pump therapy in young adults diagnosed with type 1 diabetes (DM1). However, there is limited evidence in older adults with DM1 and DM2. METHODS: A retrospective cohort study was conducted in patients ≥60 years-old with DM1 and DM2, who started Sensor Augmented Insulin Pump therapy with low-glucose suspend feature (SAP + LGS) at Hospital Universitario San Ignacio diabetes center in Bogotá, Colombia. Patients were evaluated between 2009 and 2019 and were treated with Paradigm VEO or Medtronic MiniMed 640 insulin pumps and continuous glucose monitoring system. Glycated hemoglobin (A1c), severe hypoglycemia and hypoglycemia unawareness were assessed at least every 3 months, and hospitalizations and ketoacidosis episodes incidence were assessed yearly. RESULTS: 36 patients were analyzed, (67.36 ± 4.88 years-old) (body mass index 25.48 ± 4.61 kg/m2). The most common indications for starting SAP + LGS were hypoglycemia (58.3%), high glycemic variability (25.0%) and poor metabolic control (16.7%). 26 patients used VEO (72.2%) whereas 27.8% started 640 insulin pump. Data from 32 participants showed A1c decreased from 8.57 ± 1.73% to 7.42 ± 0.96 after a year of therapy (Mean difference -1.15%, p < 0.05); 28.12% reached A1c levels <7% and 42.85% < 7.5%. There was a significant decrease in the proportion of patients with at least one severe hypoglycemia (56.7 vs 3.3%), one or more hospitalizations (20 vs 3.3%), and hypoglycemia unawareness after the first year of follow-up (p < 0.05). CONCLUSIONS: These results suggest that SAP + LGS is safe and effective in people 60 years or older after one year of therapy. Future randomized clinical trials are needed in the elderly.

Life-space assessment and associated clinical factors: SABE Colombia / Avaliação do espaço de vida e fatores clínicos associados: SABE Colômbia

OBJECTIVES: Our aim was to assess whether an association exists between chronic diseases or multimorbidity and limited life space in older adults. METHODS: This is a secondary analysis of the SABE (Salud, Bienestar y Envejecimiento) Colombia Study. We assessed chronic diseases through self-report, and a limited life space was defined as any score ≤ 60 in the Life-Space Assessment scale. Multimorbidity was defined as having two or more coexisting diseases. We performed bivariate analyses and multivariate logistic regressions aiming to obtain odds ratios with 95% confidence intervals. RESULTS: The prevalence of limited life space was 2.95% with a mean score of 76.27 ± 19.34. Statistically significant associations were found between limited life space and mental disease (OR 1.45; 95%CI 1.15 ­ 1.82) and between limited life space and multimorbidity (OR 1.32; 95%CI 1.06 ­ 1.63). CONCLUSIONS: Mental disease and multimorbidity are associated with limited life space in older adults. Therefore, preventing, diagnosing, and treating mental illness should be sought in addition to the existing preventive and therapeutic approaches available for noncommunicable diseases.

OBJETIVO: Nosso objetivo foi avaliar se existe uma associação entre doenças crônicas ou multimorbidade e espaço de vida limitado em idosos. METODOLOGIA: Esta é uma análise secundária do Estudo SABE (Salud, Bienestar y Envejecimiento) Colômbia. Avaliamos as doenças crônicas por meio de autorrelato, e espaço de vida limitado foi definido como uma pontuação ≤ 60 na escala do Life-Space Assessment. Multimorbidade foi definida como a coexistência de duas ou mais doenças. Realizamos análises bivariadas e regressões logísticas multivariadas com o objetivo de obter odds ratios com intervalos de confiança de 95%. RESULTADOS: A prevalência de espaço de vida limitado foi de 2,95% com pontuação média de 76,27 ± 19,34. Associações estatisticamente significativas foram encontradas entre espaço de vida limitado e doença mental (OR 1,45; IC95% 1,15 ­ 1,82) e entre espaço de vida limitado e multimorbidade (OR 1,32; IC95% 1,06 ­ 1,63). CONCLUSÕES: A doença mental e a multimorbidade estão associadas ao espaço de vida limitado em idosos. Portanto, deve-se buscar formas de prevenir, diagnosticar e tratar doenças mentais além das abordagens preventivas e terapêuticas atualmente disponíveis para doenças não transmissíveis

Evaluación de conocimientos sobre oxigenoterapia y lectura del flujómetro en el personal de salud de pediatría del Hospital Universitario San Ignacio, Bogotá, Colombia / Knowledge Evaluation of Oxygen Therapy and Flowmeter's Reading among Health Workers in the Pediatric Unit at Hospital Universitario San Ignacio, Bogotá, Colombia

Introducción: el oxígeno (O2) es un medicamento que puede generar efectos adversos. Discrepancias en la lectura del flujómetro y metas de saturación de oxígeno (SpC>2) pueden repercutir en la toma de decisiones clínicas, paraclínicas y estancia hospitalaria de pacientes pediátricos. Objetivo: evaluar conocimientos sobre SpO2, efectos adversos del O2 y lectura del flujómetro en el personal de salud del Departamento de Pediatría del Hospital Universitario San Ignacio, Bogotá, Colombia. Métodos: estudio transversal, mediante encuesta autodiligenciada en una muestra por conveniencia durante diciembre de 2016 y enero de 2017. Evaluación de conocimientos sobre oxigenoterapia, SpC>2, efectos adversos y lectura del flujómetro mediante fotografías de flujómetros del hospital con diferente fracción inspirada de oxígeno (FiC>2). Resultados: de 259 personas, el 77% respondió la encuesta. El 22% de los participantes respondió que la SpC>2 aumenta o se mantiene igual cuando el niño duerme; el 78% sabía de complicaciones del uso prolongado de O2, y el 67%, las relacionadas con la administración de una FiC>2 mayor a la necesaria. Con relación a la población neonatal, el 10% consideró que se deben buscar metas de SpO2 iguales o superiores al 96%; entre el 9% y el 19% de las lecturas en las diferentes fotografías de flujómetros fueron respuestas incorrectas. Discusión: es necesario reforzar conceptos actualizados sobre oxigenoterapia, con énfasis en metas de saturación, efectos adversos y lectura de flujómetro mediante campañas educativas periódicas.

Introduction: Supplemental oxygen is considerad a pharmaceutical drug; therafora, it can produce adverse effects. Lack of consensus regarding the reading of oxygen flowmeters and peripheral oxygen saturation (SpC>2) goals can influence clinical and paraclinical decisions and hospital stay length. Objective: To assess knowledge on oxygen therapy, adverse effects, SpC>2 goals and oxygen flowmeter's reading among personnel in the Pediatric Unit at Hospital Universitario San Ignacio, Bogotá, Colombia. Methodology: Cross-sectional study derived from convenience sampling through a self-applied poli between December 2016 and January 2017. The poli evaluated topics on supplemental oxygen therapy fundamentáis and adverse effects, SpC>2 goals and flowmeter readings through flowmeters photographs indicating a specific ffaction of inspirad oxygen (FÍO2). Results: Response rate was 77% from 259 subjects. 22% considered that the oxygen saturation either increases or remains the same during sleep periods in children. 78% participants knew at least one complication associated to prolonged oxygen therapy and 67% due to supplementary oxygen concentration greater than required amounts. In neonatal population, 10% considered oxygen saturation efectos adversos y lectura de flujómetro mediante campañas educativas periódicas.

Anciano con diabetes y factores asociados. Estudio SABE, Bogotá, Colombia / The elderly with diabetes and associated factors. SABE study, Bogotá, Colombia

Resumen Objetivo: conocer el autorreporte de diabetes en la población de adultos mayores de la ciudad de Bogotá y su asociación con variables sociodemográficas, del estado de salud y medidas antropométricas. Diseño: estudio observacional y poblacional de corte transversal analítico. Marco de referencia: datos del estudio SABE (Encuesta de Salud, Bienestar y Envejecimiento) Bogotá, Colombia. Participantes: mil novecientos noventa y nueve personas de 60 años o más de Bogotá, Colombia. Mediciones: variables sociodemográficas, enfermedades, hábitos, actividad física, tratamiento, evaluación cognitiva y afectiva, estado funcional y medidas antropométricas. Se realizaron análisis bivariados y multivariados con el paquete estadístico SAS (versión 9.4). Resultados: las personas tenían edad promedio de 71.2 ±8.0 y 62% eran mujeres; el 17.5% autorreportó diagnóstico de diabetes. En el análisis multivariado, la diabetes estuvo asociada con la presencia de hipertensión (OR = 1.62 95% intervalos de confianza IC = 1.20-1.18), catarata (OR = 1.71 95% IC = 1.24-2.36) y con perímetro abdominal aumentado (OR = 1.03 95% IC = 1.021.04). También estuvo asociada con una menor fuerza de agarre (OR = 0.98 95% IC = 0.96-0.99). Conclusión: la prevalencia de DM según autorreporte en Bogotá se encuentra en 17.5% de la población encuestada y representa una de las prevalencias más altas dentro de las ciudades latinoamericanas y del Caribe en donde se llevó a cabo el estudio SABE. (Acta Med Colomb 2017; 42: 230-236).

Abstract Objective: to know the self-report of diabetes in the elderly population of the city of Bogotá and its association with sociodemographic variables, health status and anthropometric measures. Design: population-based observational analytical cross-sectional study. Reference frame: data from the SABE study (Health, Well-being and Aging Survey) Bogotá, Colombia. Participants: one thousand nine hundred and ninety-nine people aged 60 or more from Bogotá, Colombia. Measurements: sociodemographic variables, diseases, habits, physical activity, treatment, cognitive and affective evaluation, functional status and anthropometric measurements. Bi-varied and multivariate analyzes were performed with the statistical package SAS (version 9.4). Results: patients had an average age of 71.2 ± 8.0 and 62% were women; 17.5% made self-report diagnosis of diabetes. In the multivariate analysis, diabetes was associated with the presence of hypertension (OR = 1.62 CI 95% confidence intervals = 1.20-1.18), cataract (OR = 1.71 IC 95% = 1.24-2.36) and increased abdominal circumference (OR = 1.03 IC 95% = 1.02-1.04). It was also associated with lower grip strength (OR = 0.98 95% IC = 0.96-0.99). Conclusion: the prevalence of DM according to self-report in Bogotá is found in 17.5% of the surveyed population and represents one of the highest prevalence in the Latin American and Caribbean cities where the SABE study was carried out. (Acta Med Colomb 2017; 42: 230-236).

Dolor en el anciano: calidad de vida, funcionalidad y factores asociados. Estudio SABE, Bogotá, Colombia / Pain in the elderly: Quality of life, functionality and associated factors. SABE Study, Bogotá, Colombia

Objetivo. Precisar el impacto del dolor en la calidad de vida y en la funcionalidad de la población anciana. Materiales y métodos. Se analizaron los datos del estudio SABE-Bogotá, que incluyó 2.000 personas de 60 años o más en una muestra transversal probabilística por conglomerados (cobertura del 81,9%). Se utilizó la variable «Presencia de dolor» y se relacionó con los factores sociodemográficos, la autopercepción de salud, las comorbilidades, el estado funcional, el estado cognoscitivo y la calidad de vida, esta última estimada con la Escala visual analógica del grupo EuroQOL. Resultados. La mayoría de los ancianos encuestados fueron mujeres (63,4%), y la edad promedio fue de 71,17 años (DE = 8,05), con una mayoría de individuos entre los 60 y 69 años (48%). Al comparar los grupos con dolor versus no dolor, se encontraron puntajes significativamente más bajos en el grupo con dolor (p < 0,001) tanto en las escalas de funcionalidad como en la de calidad de vida EQ-VAS. Las asociaciones más fuertes con el dolor fueron las enfermedades articulares (OR: 3,08 [2,24-4,23]), la depresión severa (OR: 2,80 [1,63-4,79]) y el compromiso funcional de las actividades básicas de la vida diaria (ABVD) (OR: 2,45 [1,31-4,58]). Conclusiones. El dolor impacta negativamente en la independencia funcional y la percepción de calidad de vida de las personas adultas mayores, predisponiéndolas a desenlaces adversos (AU)

Objective. To determine the impact of pain on the quality of life in older adults and its association with functionality. Materials and methods. Data was taken from SABE Bogota study. A cross-sectional study was carried out during 2012, interviewing 2,000 individuals of 60 years and older, as a probabilistic cluster and representative sample. The variable ‘presence of pain’ to was used to identify associations with sociodemographic factors, self-rated health, comorbidities, functional status, cognitive status, and quality of life. The latter was estimated using a visual analogue scale of the EuroQOL tool (EQ-VAS). Results. The majority of older adults were women (63.4%); the mean age was 71.17 years (SD = 8.05), with a higher frequency of individuals in the age group between 60 and 69 years (48%). When comparing groups with pain vs. no pain, significantly lower scores were found in the group with pain (P < .001) in both the functionality and quality of life EQ-VAS scales. The strongest associations with pain were: joint diseases (OR: 3.08 [2.24-4.23]), severe depression (OR: 2.80 [1.63-4.79]) and functional impairment of the Basic Activities of Daily Living (BADL) (OR: 2.45 [1.31-4.58]). Conclusions. Pain negatively impacts the functional independence and the perception of the quality of life in older adults, predisposing them to adverse outcomes (AU)

[Pain in the elderly: Quality of life, functionality and associated factors. SABE Study, Bogotá, Colombia]. / Dolor en el anciano: calidad de vida, funcionalidad y factores asociados. Estudio SABE, Bogotá, Colombia.

OBJECTIVE: To determine the impact of pain on the quality of life in older adults and its association with functionality. MATERIALS AND METHODS: Data was taken from SABE Bogota study. A cross-sectional study was carried out during 2012, interviewing 2,000 individuals of 60 years and older, as a probabilistic cluster and representative sample. The variable 'presence of pain' to was used to identify associations with sociodemographic factors, self-rated health, comorbidities, functional status, cognitive status, and quality of life. The latter was estimated using a visual analogue scale of the EuroQOL tool (EQ-VAS). RESULTS: The majority of older adults were women (63.4%); the mean age was 71.17 years (SD=8.05), with a higher frequency of individuals in the age group between 60 and 69years (48%). When comparing groups with pain vs. no pain, significantly lower scores were found in the group with pain (P<.001) in both the functionality and quality of life EQ-VAS scales. The strongest associations with pain were: joint diseases (OR: 3.08 [2.24-4.23]), severe depression (OR: 2.80 [1.63-4.79]) and functional impairment of the Basic Activities of Daily Living (BADL) (OR: 2.45 [1.31-4.58]). CONCLUSIONS: Pain negatively impacts the functional independence and the perception of the quality of life in older adults, predisposing them to adverse outcomes.