Author: María del Carmen García Peña

Validity of knee-estimated height to assess standing height in older adults: a secondary longitudinal analysis of the Mexican health and aging study

María del Carmen García Peña (2017)

Abstract:

OBJECTIVE:

The main objective was to test the validity of height estimated by knee height in Mexican older adults, as a surrogate for standing height.

DESIGN:

Cohort study.

SETTING:

Data were drawn from the first and third waves of the Mexican Health and Aging Study.

PARTICIPANTS:

Included participants were community-dwelling 50-year or older adults with measured height at baseline and in follow-up. Subjects with a lower limb fracture in the follow-up were excluded.

MEASUREMENTS:

Main measurements were baseline standing height and 11-year follow-up and knee-estimated height in follow-up. Population specific equations were used to estimate standing height from knee height. Comparisons between baseline standing height and knee-derived height were done with simple correlations, limits of agreement (Bland-Altman plot) and Deming regressions.

RESULTS:

A total of 136 50-year or older adults were followed-up for eleven years, with a mean age of 60. There was a positive correlation between knee-estimated height and baseline standing height of 0.895 (p<0.001) for men and of 0.845 (p<0.001) for women. Limits of agreement for men were from -6.95cm to 7.09cm and for women from -6.58cm to 8.44cm.

CONCLUSION:

According to our results, knee-estimated height could be used interchangeably with standing height in Mexican older adults, and these results might apply also to other populations.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Estado de salud Evaluación geriátrica Constitución corporal Pesos y medidas corporales Índice de masa corporal Geriatrics Health status Geriatric assessment Body constitution Body, weights and measures Body mass index

Validity of knee-estimated height to assess standing height in older adults: a secondary longitudinal analysis of the Mexican health and aging study

María del Carmen García Peña (2017)

Abstract:

OBJECTIVE:

The main objective was to test the validity of height estimated by knee height in Mexican older adults, as a surrogate for standing height.

DESIGN:

Cohort study.

SETTING:

Data were drawn from the first and third waves of the Mexican Health and Aging Study.

PARTICIPANTS:

Included participants were community-dwelling 50-year or older adults with measured height at baseline and in follow-up. Subjects with a lower limb fracture in the follow-up were excluded.

MEASUREMENTS:

Main measurements were baseline standing height and 11-year follow-up and knee-estimated height in follow-up. Population specific equations were used to estimate standing height from knee height. Comparisons between baseline standing height and knee-derived height were done with simple correlations, limits of agreement (Bland-Altman plot) and Deming regressions.

RESULTS:

A total of 136 50-year or older adults were followed-up for eleven years, with a mean age of 60. There was a positive correlation between knee-estimated height and baseline standing height of 0.895 (p<0.001) for men and of 0.845 (p<0.001) for women. Limits of agreement for men were from -6.95cm to 7.09cm and for women from -6.58cm to 8.44cm.

CONCLUSION:

According to our results, knee-estimated height could be used interchangeably with standing height in Mexican older adults, and these results might apply also to other populations.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Estado de salud Evaluación geriátrica Constitución corporal Pesos y medidas corporales Índice de masa corporal Geriatrics Health status Geriatric assessment Body constitution Body, weights and measures Body mass index

Validity of knee-estimated height to assess standing height in older adults: a secondary longitudinal analysis of the Mexican health and aging study

María del Carmen García Peña (2017)

Abstract:

OBJECTIVE:

The main objective was to test the validity of height estimated by knee height in Mexican older adults, as a surrogate for standing height.

DESIGN:

Cohort study.

SETTING:

Data were drawn from the first and third waves of the Mexican Health and Aging Study.

PARTICIPANTS:

Included participants were community-dwelling 50-year or older adults with measured height at baseline and in follow-up. Subjects with a lower limb fracture in the follow-up were excluded.

MEASUREMENTS:

Main measurements were baseline standing height and 11-year follow-up and knee-estimated height in follow-up. Population specific equations were used to estimate standing height from knee height. Comparisons between baseline standing height and knee-derived height were done with simple correlations, limits of agreement (Bland-Altman plot) and Deming regressions.

RESULTS:

A total of 136 50-year or older adults were followed-up for eleven years, with a mean age of 60. There was a positive correlation between knee-estimated height and baseline standing height of 0.895 (p<0.001) for men and of 0.845 (p<0.001) for women. Limits of agreement for men were from -6.95cm to 7.09cm and for women from -6.58cm to 8.44cm.

CONCLUSION:

According to our results, knee-estimated height could be used interchangeably with standing height in Mexican older adults, and these results might apply also to other populations.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Estado de salud Evaluación geriátrica Constitución corporal Pesos y medidas corporales Índice de masa corporal Geriatrics Health status Geriatric assessment Body constitution Body, weights and measures Body mass index

Predictive value of frailty indexes for adverse outcomes in older adults

MARIO ULISES PEREZ ZEPEDA Matteo Cesari María del Carmen García Peña (2016)

Abstract: Background: There are two widely used tools to classify frailty in older adults: the frailty phenotype and the frailty index. Both have been validated for prediction of adverse outcomes. Objective: To assess the ability of different frailty indices to predict a number of adverse outcomes (falls, disability, and mortality) by adding deficits in a fixed sequence (with the first five deficits as in the frailty phenotype: weakness, weight loss, slowness, exhaustion and low physical activity) or randomly. Methods: This is an analysis of the Costa-Rican Longevity and Healthy Aging Study in which ≥ 60-year-old adults were included and followed up for four years. Frailty indices were constructed, including the frailty phenotype components in the first five indices followed by the random addition of other deficits and estimating for each one the odds ratios for falls and disability and hazard ratios for mortality, adjusted for age and sex. Results: We included 2,708 adults; mean age was 76.31 years, 54.28% were women. Indices with the highest number of deficits had the highest estimates for each adverse outcome, independent of the deficit. Conclusion: The higher the number of deficits in an index, the higher the estimates for adverse outcomes, independent of the type of deficit added.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Condiciones patológicas (signos y síntomas) Procesos patológicos Fragilidad Salud pública Accidentes Caídas accidentales Personas mayores Geriatrics Pathological conditions (signs and symptoms) Pathologic processes Frailty Public health Accidents Accidental falls Aged

Predictive value of frailty indexes for adverse outcomes in older adults

MARIO ULISES PEREZ ZEPEDA Matteo Cesari María del Carmen García Peña (2016)

Abstract: Background: There are two widely used tools to classify frailty in older adults: the frailty phenotype and the frailty index. Both have been validated for prediction of adverse outcomes. Objective: To assess the ability of different frailty indices to predict a number of adverse outcomes (falls, disability, and mortality) by adding deficits in a fixed sequence (with the first five deficits as in the frailty phenotype: weakness, weight loss, slowness, exhaustion and low physical activity) or randomly. Methods: This is an analysis of the Costa-Rican Longevity and Healthy Aging Study in which ≥ 60-year-old adults were included and followed up for four years. Frailty indices were constructed, including the frailty phenotype components in the first five indices followed by the random addition of other deficits and estimating for each one the odds ratios for falls and disability and hazard ratios for mortality, adjusted for age and sex. Results: We included 2,708 adults; mean age was 76.31 years, 54.28% were women. Indices with the highest number of deficits had the highest estimates for each adverse outcome, independent of the deficit. Conclusion: The higher the number of deficits in an index, the higher the estimates for adverse outcomes, independent of the type of deficit added.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Condiciones patológicas (signos y síntomas) Procesos patológicos Fragilidad Salud pública Accidentes Caídas accidentales Personas mayores Geriatrics Pathological conditions (signs and symptoms) Pathologic processes Frailty Public health Accidents Accidental falls Aged

Predictive value of frailty indexes for adverse outcomes in older adults

MARIO ULISES PEREZ ZEPEDA Matteo Cesari María del Carmen García Peña (2016)

Abstract: Background: There are two widely used tools to classify frailty in older adults: the frailty phenotype and the frailty index. Both have been validated for prediction of adverse outcomes. Objective: To assess the ability of different frailty indices to predict a number of adverse outcomes (falls, disability, and mortality) by adding deficits in a fixed sequence (with the first five deficits as in the frailty phenotype: weakness, weight loss, slowness, exhaustion and low physical activity) or randomly. Methods: This is an analysis of the Costa-Rican Longevity and Healthy Aging Study in which ≥ 60-year-old adults were included and followed up for four years. Frailty indices were constructed, including the frailty phenotype components in the first five indices followed by the random addition of other deficits and estimating for each one the odds ratios for falls and disability and hazard ratios for mortality, adjusted for age and sex. Results: We included 2,708 adults; mean age was 76.31 years, 54.28% were women. Indices with the highest number of deficits had the highest estimates for each adverse outcome, independent of the deficit. Conclusion: The higher the number of deficits in an index, the higher the estimates for adverse outcomes, independent of the type of deficit added.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Condiciones patológicas (signos y síntomas) Procesos patológicos Fragilidad Salud pública Accidentes Caídas accidentales Personas mayores Geriatrics Pathological conditions (signs and symptoms) Pathologic processes Frailty Public health Accidents Accidental falls Aged

Impact of social disadvantages in the presence of diabetes at old age

MARIA FERNANDA CARRILLO VEGA CIDRONIO ALBAVERA HERNANDEZ RICARDO RAMIREZ ALDANA María del Carmen García Peña (2019)

Background

Social disadvantages that start during childhood and continue into the later stages in life may be linked to the presence of diabetes during adulthood. Objective. To analyze whether the presence of social disadvantages in childhood and in the present affects the presence of diabetes in older adults.

Methods

The present study was based on longitudinal data from the third and fourth Mexican Health and Aging Study (MHAS) waves (2012 and 2015). Data on diabetes diagnosis, past (e.g. “no shoes during childhood”) and present (e.g. self-perception of economic status) social disparities, and other covariables were analyzed.

Results

From 8,848 older adults, 21.5% (n = 1903) were classified as prevalent cases (PG), 5.2% (n = 459) as incident cases (IG) and 77.4% (n = 6,486) were free of disease (NDG). The predictor variable “no shoes during childhood” was statistically significant in the model incident versus no diabetes group. Hypertension and body mass index (BMI) were the most relevant covariates as they were statistically significant in the three groups (PG, IG and NDG).

Conclusions

Not having shoes during childhood, an indicator of social disadvantages, is associated with the incidence and prevalence of diabetes in older adults. This suggests that social disadvantages can be a determinant for the presence of chronic diseases in adulthood.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias Clínicas Geriatría Enfermedades del sistema endócrino Diabetes Mellitus Grupos de edad Personas Mayores Experiencias adversas de la niñez Geriatrics Endocine system diseases Diabetes Mellitus Age groups Elderly Adverse childhood experiences

Gasto de bolsillo en salud durante el último año de vida de adultos mayores mexicanos: análisis del ENASEM

Out of pocket expenditure on health during the last year of life of Mexican elderly: analysis of the Enasem

GUILLERMO SALINAS ESCUDERO MARIA FERNANDA CARRILLO VEGA MARIO ULISES PEREZ ZEPEDA María del Carmen García Peña (2019)

Objetivo. Estimar el gasto de bolsillo (GB) durante el último año de vida en adultos mayores (AM) mexicanos. Material y métodos. Estimación del GB del último año de vida de AM, ajustando por tipo de manejo, afiliación y causa de muerte. Se emplearon datos del Estudio Nacional de Salud y Envejecimiento en México (2012). Los gastos en medicamentos, consultas médicas y hospitalización durante el año previo a la muerte conforman el GB. El GB se ajustó por inflación y se reporta en dólares americanos 2018. Resultados. La media de GB fue $6 255.3±18 500.En el grupo de atención ambulatoria el GB fue $4 134.9±13 631.3. El GB en hospitalización fue $7 050.6±19 971.0. Conclusiones. La probabilidad de incurrir en GB es menor cuando no se requiere hospitalización. Con hospitalización, la afiliación a la seguridad social y atenderse en hospitales públicos juega un papel protector.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias Clínicas Geriatría Grupos de edad Personas mayores Atención al paciente Cuidado terminal Gasto de bolsillo Seguridad social (México) Geriatrics Age groups Elderly Patient care Terminal care Out of pocket expenditure Social security (Mexico)

Individual and cumulative association of commonly used biomarkers on frailty: a cross-sectional analysis of the Mexican Health and Aging Study

MARIO ULISES PEREZ ZEPEDA María del Carmen García Peña MARIA FERNANDA CARRILLO VEGA (2019)

Frailty has been recognized as a common condition in older adults, however, there is scarce information on the association between frailty and commonly used biomarkers. The aim of this study was to assess the individual and cumulative association of biomarkers with frailty status. This is a cross-sectional analysis of the 2012 wave of the Mexican Health and Aging Study. A sub-sample of 60-year or older adults with anthropometric measurements was analyzed. Frailty was defined with a 31-item frailty index and those considered frail had a score ≥ 0.21. Biomarkers were further categorized as normal/abnormal and tested both one by one and grouped (according to their usual cutoff values). Adjusted logistic models were performed. A total of 1128 older adults were analyzed and their mean age was 69.45 years and 51.24% of them were women. 26.7% (n = 301) were categorized as frail. Individual biomarkers associated with frailty after adjusting for confounding were: hemoglobin [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.13–2.46, p = 0.009], glycated hemoglobin (OR 2.04, 95% CI 1.54–2.7, p < 0.001) and vitamin D (OR 1.53, 95% CI 1.13–2.07, p = 0.005). Those with ≥ 4 abnormal biomarkers had an independent association with frailty when compared to those without any abnormal biomarker (OR 2.64, 95% CI 1.3–5.25, p = 0.005). Aside from the individual associations of specific biomarkers, our findings show that an incremental association of abnormal biomarkers increases the probability of frailty, accounting for the multidimensional nature of frailty and the possible interplay between components of the system that potentiate to give rise to a negative condition such as frailty.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias Clínicas Geriatría Condiciones patológicas, signos y síntomas Procesos patológicos Fragilidad Personas Mayores Envejecimiento Epidemiología geriátrica Geriatrics Pathological conditions, signs and symptoms Pathologic processes Frailty Older adults Aging Geriatric epidemiology

Multimorbidity, Depressive Symptoms, and Self-Reported Health in Older Adults: a Secondary Analysis of the Sabe Bogota Study

Daniela Camargo SILVIA LILIANA SUAREZ MONSALVE MARIO ULISES PEREZ ZEPEDA María del Carmen García Peña Carlos Cano (2018)

Background: Multimorbidity and depressive symptoms (DSs) are common in older adults. Self-rated health (SRH) allows detection of elderly adults with a high burden of multimorbidity plus depression. The aim of this study was to test the association of groups of multimorbidity and DS on SRH in Colombian older adults.

Methods: We conducted a cross-sectional study in 2012 in Bogotá, Colombia, called “Salud, Bienestar y Envejecimiento” (Health, Well-being, and Aging), including 2000 community-dwelling adults 60 years of age or older. SRH was assessed with the question “How would you rate your health?” giving five possible answers. DSs were rated using the 15-question version of the geriatric depression scale, and multimorbidity was defined as having two or more chronic diseases. A logistic regression model was used to identify the association between grouped DS and multimorbidity with SRH.

Results: Groups were distributed as follows: 678 with no DS/no multimorbidity (33.9%), 808 with only multimorbidity (40%), 128 with DS only (6.4%), and 386 with DS/multimorbidity (19.3%). An association of fair/poor SRH with DS/multimorbidity group was found (odds ratio 5.5; 95% confidence interval 3.86-7.95, p < 0.001) when compared to subjects without any of those conditions. Conclusion: There was an incremental association between DS and multimorbidity with SRH. An older adult referring to his or her own health with a negative connotation should alert to a higher burden of diseases, including DS.

Article

MEDICINA Y CIENCIAS DE LA SALUD BIOLOGÍA Y QUÍMICA Multimorbilidad Depresión Autoevaluación diagnóstica Envejecimiento Multimorbidity Depression Diagnostic Self Evaluation Aging