Author: VICTORIA EUGENIA ARANGO LOPERA

The state of elder care in Mexico

Luis Miguel Gutiérrez Robledo MARIANA LOPEZ ORTEGA VICTORIA EUGENIA ARANGO LOPERA (2012)

El nueve por ciento (10.05 millones) de la población mexicana tiene más de 60 años, con un crecimiento anual en la última década cercano al 4% y un patrón de envejecimiento femenino. Los miembros de este grupo viven predominantemente en áreas urbanas (74%), son casados ​​o tienen un compañero (60%), y generalmente tienen niveles muy bajos de educación. Sin embargo, otras fuentes de datos de salud muestran que el 43% de la población anciana ha tenido al menos una caída en el último año, y 43 % experimentaron síntomas de depresión. Además, se informó que el 10% tenía declinación cognitiva. Las principales causas de mortalidad reportadas son la diabetes y las enfermedades cardiovasculares y pulmonares. Los servicios de salud y los usuarios se dividen según la institución de salud que presta el servicio. Hay tres proveedores principales: 1) instituciones de seguridad social; 2) servicios públicos ofrecidos por el Ministerio de Salud; y 3) proveedores del sector privado. En 2008, se fundó en México el Instituto Nacional del Envejecimiento (INGER). En los próximos cinco años, el Instituto se centrará en el desarrollo, la operación y la evaluación del nuevo sistema de atención de la tercera edad y la educación gerontológica / geriátrica, con una fuerte perspectiva basada en la evidencia. Además, continuará el desarrollo de la investigación biológica, clínica, tecnológica y biomédica. México debe continuar construyendo programas y políticas con una perspectiva de derechos humanos y orientada a la adaptación de la atención de salud a las necesidades de los ancianos. Específicamente, debe centrarse en proporcionar a los ancianos atención primaria, educación y recursos para evitar la dependencia funcional y mejorar el envejecimiento activo y saludable, así como en el acceso creciente a un sistema de información adecuado y capacitación especializada para recursos humanos que sea dedicado a la atención de los ancianos.

Article

MEDICINA Y CIENCIAS DE LA SALUD CIENCIAS SOCIALES Geriatría Envejecimiento Cuidado de la salud Salud Políticas México Geriatrics Aging Delivery of Health Care Health Policy INGER

The state of elder care in Mexico

Luis Miguel Gutiérrez Robledo MARIANA LOPEZ ORTEGA VICTORIA EUGENIA ARANGO LOPERA (2012)

El nueve por ciento (10.05 millones) de la población mexicana tiene más de 60 años, con un crecimiento anual en la última década cercano al 4% y un patrón de envejecimiento femenino. Los miembros de este grupo viven predominantemente en áreas urbanas (74%), son casados ​​o tienen un compañero (60%), y generalmente tienen niveles muy bajos de educación. Sin embargo, otras fuentes de datos de salud muestran que el 43% de la población anciana ha tenido al menos una caída en el último año, y 43 % experimentaron síntomas de depresión. Además, se informó que el 10% tenía declinación cognitiva. Las principales causas de mortalidad reportadas son la diabetes y las enfermedades cardiovasculares y pulmonares. Los servicios de salud y los usuarios se dividen según la institución de salud que presta el servicio. Hay tres proveedores principales: 1) instituciones de seguridad social; 2) servicios públicos ofrecidos por el Ministerio de Salud; y 3) proveedores del sector privado. En 2008, se fundó en México el Instituto Nacional del Envejecimiento (INGER). En los próximos cinco años, el Instituto se centrará en el desarrollo, la operación y la evaluación del nuevo sistema de atención de la tercera edad y la educación gerontológica / geriátrica, con una fuerte perspectiva basada en la evidencia. Además, continuará el desarrollo de la investigación biológica, clínica, tecnológica y biomédica. México debe continuar construyendo programas y políticas con una perspectiva de derechos humanos y orientada a la adaptación de la atención de salud a las necesidades de los ancianos. Específicamente, debe centrarse en proporcionar a los ancianos atención primaria, educación y recursos para evitar la dependencia funcional y mejorar el envejecimiento activo y saludable, así como en el acceso creciente a un sistema de información adecuado y capacitación especializada para recursos humanos que sea dedicado a la atención de los ancianos.

Article

MEDICINA Y CIENCIAS DE LA SALUD CIENCIAS SOCIALES Geriatría Envejecimiento Cuidado de la salud Salud Políticas México Geriatrics Aging Delivery of Health Care Health Policy INGER

A wii pressure platform to assess balance in the elderly

ARTURO OLVERA CHAVEZ CLARA EUGENIA GARZA HUME LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: Use of low-cost technologies could simplify assessment of balance in elderly. Objective Determine the usefulness of the Wii™ pressure board in assessing balance in elderly. Methods We conducted a cross-sectional study in a group of elderly to test their balance with the pressure board compared to conventional tests used in geriatric practice. Community-dwelling adults over 60-years old were assessed. We compared the Short Physical Performance Battery scores with the Wii force platform results (average kinetic energy). Two blinded researchers classified each set of tests; and then a weighted kappa statistic was estimated. Results We assessed a total of 20 subjects, with a median age of 67.5 years (range 60-98), 75% women. The tests were concordant in 19 of the 20 subjects; with a resulting concordance of 0.6 (p=0.05). Conclusion The Wii pressure board has a good concordance with usual clinical assessment of balance in the elderly.

Conclusion: The balance board is a promising tool regarding assessment of postural stability in elderly; in a cheap and portable fashion.

Article

INGENIERÍA Y TECNOLOGÍA Ciencias tecnológicas Tecnología médica Gerontecnología Personas mayores Caídas accidentales Modelos matemáticos Medical technology Gerontechnology Elderly Accidental falls Mathematical models

A wii pressure platform to assess balance in the elderly

ARTURO OLVERA CHAVEZ CLARA EUGENIA GARZA HUME LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: Use of low-cost technologies could simplify assessment of balance in elderly. Objective Determine the usefulness of the Wii™ pressure board in assessing balance in elderly. Methods We conducted a cross-sectional study in a group of elderly to test their balance with the pressure board compared to conventional tests used in geriatric practice. Community-dwelling adults over 60-years old were assessed. We compared the Short Physical Performance Battery scores with the Wii force platform results (average kinetic energy). Two blinded researchers classified each set of tests; and then a weighted kappa statistic was estimated. Results We assessed a total of 20 subjects, with a median age of 67.5 years (range 60-98), 75% women. The tests were concordant in 19 of the 20 subjects; with a resulting concordance of 0.6 (p=0.05). Conclusion The Wii pressure board has a good concordance with usual clinical assessment of balance in the elderly.

Conclusion: The balance board is a promising tool regarding assessment of postural stability in elderly; in a cheap and portable fashion.

Article

INGENIERÍA Y TECNOLOGÍA Ciencias tecnológicas Tecnología médica Gerontecnología Personas mayores Caídas accidentales Modelos matemáticos Medical technology Gerontechnology Elderly Accidental falls Mathematical models

A wii pressure platform to assess balance in the elderly

ARTURO OLVERA CHAVEZ CLARA EUGENIA GARZA HUME LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: El uso de tecnologías de bajo costo podría simplificar la evaluación del equilibrio en los ancianos. Objetivo: determinar la utilidad de la placa de presión Wii ™ en la evaluación del equilibrio en los ancianos. Métodos: se realizó un estudio transversal en un grupo de ancianos para probar su equilibrio con el tablero de presión en comparación con las pruebas convencionales utilizadas en la práctica geriátrica. Se evaluaron los adultos mayores de 60 años que vivían en la comunidad. Comparamos los resultados de la batería de rendimiento físico corto con los resultados de la plataforma de fuerza de Wii (energía cinética promedio). Dos investigadores ciegos clasificaron cada conjunto de pruebas; y luego se estimó un estadístico kappa ponderado. Resultados: se evaluó un total de 20 sujetos, con una mediana de edad de 67,5 años (rango 60-98), 75% de mujeres. Las pruebas fueron concordantes en 19 de los 20 sujetos; Con una concordancia resultante de 0,6 (p = 0,05). Conclusión: el tablero de presión Wii tiene una buena concordancia con la evaluación clínica habitual del equilibrio en los ancianos.

Article

INGENIERÍA Y TECNOLOGÍA Ciencias tecnológicas Tecnología médica Gerontecnología Personas mayores Caídas accidentales Modelos matemáticos Medical technology Gerontechnology Elderly Accidental falls Mathematical models

Handgrip strength predicts functional decline at discharge in hospitalized male elderly: a hospital cohort study

María del Carmen García Peña Luis Cuitlahuac García-Fabela LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO JOSE JUAN GARCIA GONZALEZ VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting) at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.). A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7%) had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79–0.98, p = 0.01), with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline, and intervene consequently.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Métodos de evaluación geriátrica Fisiología de la fuerza de la mano Personas mayores Adultos México Geriatrics Geriatric assessment metods Hand strenght physiology Elderly Aged

Handgrip strength predicts functional decline at discharge in hospitalized male elderly: a hospital cohort study

María del Carmen García Peña Luis Cuitlahuac García-Fabela LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO JOSE JUAN GARCIA GONZALEZ VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting) at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.). A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7%) had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79–0.98, p = 0.01), with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline, and intervene consequently.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Métodos de evaluación geriátrica Fisiología de la fuerza de la mano Personas mayores Adultos México Geriatrics Geriatric assessment metods Hand strenght physiology Elderly Aged

Handgrip strength predicts functional decline at discharge in hospitalized male elderly: a hospital cohort study

María del Carmen García Peña Luis Cuitlahuac García-Fabela LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO JOSE JUAN GARCIA GONZALEZ VICTORIA EUGENIA ARANGO LOPERA MARIO ULISES PEREZ ZEPEDA (2013)

Abstract: Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting) at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.). A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7%) had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79–0.98, p = 0.01), with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline, and intervene consequently.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Métodos de evaluación geriátrica Fisiología de la fuerza de la mano Personas mayores Adultos México Geriatrics Geriatric assessment metods Hand strenght physiology Elderly Aged