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31 results, page 1 of 4

Vitamin D deficiency in older adults and its associated factors: a cross-sectional analysis of the Mexican Health and Aging Study

MARIA FERNANDA CARRILLO VEGA María del Carmen García Peña LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO MARIO ULISES PEREZ ZEPEDA (2017)

Vitamin D deficiency was common in older adults from a country with adequate sun exposure. The variables associated with this deficiency provide insight into the next steps needed to characterize older adults with this deficiency and to treat it accordingly.

Purpose: The aim of this study was to describe the prevalence of and factors associated with vitamin D deficiency among Mexican older adults.

Methods: This was a secondary analysis of the last wave of the Mexican Health and Aging Study. Vitamin D levels along with other biomarkers were obtained from a sub-sample of Mexican adults older than 60 years. Prevalence was described by sex and age group, and a multivariate analysis was performed to test the factors associated with this condition.

Results: Data from 1088 adults over the age of 60 years were analyzed. The mean serum vitamin D level was 23.1 ± 8.1 ng/mL and was significantly higher among men than women (25.6 ± 0.6 and 22.8 ± 0.5 ng/mL, respectively; p < 0.001). In total, 37.3% (n = 406) presented with vitamin D deficiency, 65% of whom were women. Low 25-(OH)-vitamin D levels were associated with female sex (OR 1.74, 95% CI 1.59-2.42), current smoking (OR 2.21, 95% CI 1.47-3.39), education (OR 1.1, 95% CI 1.06-1.13), physical activity (OR 1.74, 95% CI 1.31-2.23), and high levels of glycated hemoglobin (OR 1.16, 95% CI 1.07-1.25).

Conclusions: Vitamin D deficiency was highly prevalent in Mexican older adults and was associated with a number of factors, indicating the multifactorial causality of this deficiency.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Personas mayores Older adults Envejecimiento Aging Nutrición geriátrica Geriatric nutrition Epidemiología del envejecimiento Epidemiology of aging Micronutrientes Micronutrients Vitamina D Vitamin D México Mexico

Cross-cultural adaptation and validation of the spanish language version of the SARC-F to assess sarcopenia in Mexican community-dwelling older adults

LORENA PARRA RODRIGUEZ Claudia Szlejf Ana Isabel García González Theodore Malmstrom ESTEBAN CRUZ ARENAS OSCAR ROSAS CARRASCO (2016)

Objectives: To cross-culturally adapt and validate the Spanish-language version of the SARC-F in Mexican community-dwelling older adults.

Design: Cross-sectional analysis of a prospective cohort.

Setting: The FraDySMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City.

Participants: Participants were 487 men and women older than 60 years, living in the designated area in Mexico City.

Measurements: Information from questionnaires regarding demographic characteristics, comorbidities, mental status, nutritional status, dependence in activities of daily living, frailty, and quality of life. Objective measurements of muscle mass, strength and function were as follows: skeletal muscle mass index (SMI) was taken using dual-energy x-ray, grip strength using a hand dynamometer, 6-meter gait speed using a GAIT Rite instrumented walkway, peak torque and power for knee extension using a isokinetic dynamometer, lower extremity functioning measured by the Short Physical Performance Battery (SPPB), and balance using evaluation on a foam surface, with closed eyes, in the Modified Clinical Test of Sensory Integration. The SARC-F scale translated to Spanish and the consensus panels' criteria from European, international, and Asian sarcopenia working groups were applied to evaluate sarcopenia.

Results: The Spanish language version of the SARC-F scale showed reliability (Cronbach alfa = 0.641. All items in the scale correlated to the scale's total score, rho = 0.43 to 0.76), temporal consistency evaluated by test-retest (CCI = 0.80), criterion validity when compared to the consensus panels' criteria (high specificity and negative predictive values). The scale was also correlated to other measures related to sarcopenia (such as age, quality of life, self-rated health status, cognition, dependence in activities of daily living, nutritional status, depression, gait speed, grip strength, peak torque and power for knee extension, SPPB, balance, SMI, and frailty).

Conclusion: The SARC-F scale was successfully adapted to Spanish language and validated in community-dwelling Mexican older adults.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Personas mayores Older adults Fragilidad Frailty Dinapenia Dynapenia Sarcopenia Mexico

Singularidad y fragilidad. De la predicción a la acción

LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO (2017)

No han de ser más las medias o desviaciones estándar demostradas en los estudios científicos las que determinen el abordaje clínico en función de la supuesta pertenencia a una u otra categoría específicas. Contrariamente a una perspectiva dominante que pone el acento en lo que sería común a diferentes personas, vivimos una transición hacia el reconocimiento de que cada enfermo es completamente distinto de los demás. En efecto, sus diferencias, su particularidad, su singularidad, se convierten en la brújula del abordaje terapéutico.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Personas mayores Older adults Envejecimiento Aging Fragilidad Frailty Índice de fragilidad Frailty index Valoración geriátrica integral Comprehensive geriatric assessment

Multimorbidity patterns in older adults: An approach to the complex interrelationships among chronic diseases

DOLORES MINO LEON HORTENSIA REYES MORALES SVETLANA VLADISLAVOVNA DOUBOVA Ricardo Perez-Cuevas MARTHA LILIANA GIRALDO RODRIGUEZ Marcela Agudelo Botero (2017)

Background and aims: There is a growing need for evidence based answers to multimorbidity, especially in primary care settings. The aim was estimate the prevalence and patterns of multimorbidity in a Mexican population of public health institution users ≥60 years old.

Methods: Observational and multicenter study was carried out in four family medicine units in Mexico City; included older men and women who attended at least one consultation with their family doctor during 2013. The most common diseases were grouped into 11 domains. The observed and expected rates, as well as the prevalence ratios, were calculated for the pairs of the more common domains. Logistic regression models were developed to estimate the magnitude of the association. Cluster and principal components analyses were performed to identify multimorbidity patterns.

Results: Half of all of the patients who were ≥60 years old and treated by a family doctor had multimorbidity. The most common disease domains were hypertensive and endocrine diseases. The highest prevalence of multimorbidity concerned the renal domain. The domain pairs with the strongest associations were endocrine + renal and hypertension + cardiac. The cluster and principal components analyses revealed five consistent patterns of multimorbidity.

Conclusions: The domains grouped into five patterns could establish the framework for developing treatment guides, deepen the knowledge of multimorbidity, develop strategies to prevent it, decrease its burden, and align health services to the care needs that doctors face in daily practice.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Salud pública Public health Factores epidemiológicos Epidemiologic factors Multimorbilidad Multimorbidity Enfermedades crónicas Chronic diseases Atención primaria Primary health care Personas mayores Older adults

Cancer and frailty in older adults: A nested case-control study of the Mexican health and aging study

MARIO ULISES PEREZ ZEPEDA EDUARDO CARDENAS CARDENAS Matteo Cesari ANA PATRICIA NAVARRETE REYES LUIS MIGUEL FRANCISCO GUTIERREZ ROBLEDO (2016)

Purpose: Understanding how the convergence between chronic and complex diseases-such as cancer-and emerging conditions of older adults-such as frailty-takes place would help in halting the path that leads to disability in this age group. The objective of this manuscript is to describe the association between a past medical history of cancer and frailty in Mexican older adults.

Methods: This is a nested in cohort case-control study of the Mexican Health and Aging Study. Frailty was categorized by developing a 55-item frailty index that was also used to define cases in two ways: incident frailty (incident >0.25 frailty index score) and worsening frailty (negative residuals from a regression between 2001 and 2012 frailty index scores). Exposition was defined as self-report of cancer between 2001 and 2012. Older adults with a cancer history were further divided into recently diagnosed (<10 years) and remotely diagnosed (>10 years from the initial diagnosis). Odds ratios were estimated by fitting a logistic regression adjusted for confounding variables.

Results: Out of a total of 8022 older adults with a mean age of 70.6 years, the prevalence of a past medical history of cancer was 3.6 % (n = 288). Among these participants, 45.1 % had been diagnosed with cancer more than 10 years previously. A higher risk of incident frailty compared to controls [odds ratio (OR) 1.53 (95 % confidence interval (CI) 1.04-2.26, p = 0.03); adjusted model OR 1.74 (95 % CI 1.15-2.61, p = 0.008)] was found in the group with a recent cancer diagnosis. Also, an inverse association between a remote cancer diagnosis and worsening frailty was found [OR = 0.56 (95 % CI 0.39-0.8), p = 0.002; adjusted model OR 0.61 (95 % CI 0.38-0.99, p = 0.046)].

Conclusions: Cancer is associated with a higher frailty index, with a potential relevant role of the time that has elapsed since the cancer diagnosis.

Implications for cancer survivors: Cancer survivors may be more likely to develop frailty or worsening of the health status at an older age. This relationship seems especially evident among individuals with a recent oncological diagnosis. Health professionals in charge of older adult care should be aware of this association in order to improve outcomes of older adults who survived cancer.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Personas mayores Older adults Oncogeriatría Oncogeriatrics Fragilidad Frailty Enfermedades crónicas Chronic diseases Discapacidad Disability Cáncer Cancer México Mexico

Estado de nutricion del adulto mayor en Mèxico

MIGUEL ANGEL LEZANA FERNANDEZ Luis M Gutierrez Robledo PEDRO ARROYO ACEVEDO Teresa Shamah Levy Lucía Cuevas Nasu GABRIELA RIOS CAZARES (2013)

México cuenta por primera vez con información

confiable, actualizada y precisa sobre el estado

de nutrición de los adultos mayores, la cual debe

tomarse en cuenta para la generación de políticas públicas específicas dirigidas a aquellos

AM que ya padecen o están en riesgo de mala

nutrición. Asimismo, esta información permite establecer acciones para el autocuidado en

etapas tempranas de la vida, a fin de garantizar

un futuro sano y calidad de vida en los adultos

mayores, que les permita integrarse de manera productiva a las dinámicas familiar y social

para hacer esta etapa de la vida confortable

Book part

MEDICINA Y CIENCIAS DE LA SALUD Geriatría Older adults Personas mayores Envejecimiento Aging Elder Nutritional Physiological Phenomena Fenómenos fisiológicos nutricionales mayores

ESTADO DE SALUD DE LOS ANCIANOS: RESPUESTAS DEL SISTEMA DE SALUD

María del Carmen García Peña CESAR GONZALEZ GONZALEZ (2013)

El envejecimiento representa un reto sin precedentes para los servicios de salud, especialmente para el sector público que enfrenta más del 60% de la atención a la población anciana a nivel nacional, la búsqueda de esquemas de atención orientados al envejecimiento resulta una prioridad para el sistema de salud mexicano.

Book part

MEDICINA Y CIENCIAS DE LA SALUD Geriatrics Older adults Personas mayores Envejecimiento Aging Instituciones de salud Public health

COVID-19 e instituciones de cuidados a largo plazo en México: una deuda impostergable

COVID-19 and long-term care facilities in Mexico: a debt that cannot be postponed

JORGE ALBERTO MENA MADRAZO EDUARDO SOSA TINOCO MIGUEL FLORES CASTRO MARIANA LOPEZ ORTEGA Luis M Gutierrez Robledo (2020)

Ante la pandemia de COVID-19, el grupo más afectado ha sido el de las personas mayores que viven en instituciones de cuidados a largo plazo (ICLP), el cual ha acumulado entre 30 y 60 % de los fallecimientos en el mundo. En México se han reportado brotes en residencias de por lo menos ocho entidades federativas. Diversos factores hacen susceptibles a este grupo y a las ICLP: la convivencia en lugares comunes, dormitorios compartidos y el contacto físico con el personal que ahí labora, aunados a la falta de protocolos y estándares de cuidados de observancia obligatoria, así como a la escasa capacitación del personal. Se evidencia la necesidad de desarrollar un Sistema Nacional de Cuidados que brinde apoyo a las personas con dependencia de cuidados y sus familias y que incluya a las ICLP. Derivado de los retos por la carencia de información y competencias en prevención y control de infecciones en las ICLP, un conjunto de expertos, en colaboración con instituciones públicas, integramos un grupo con el objetivo de actualizar las guías que permitan a las ICLP hacer frente a la pandemia y que contribuyan a la generación de ese Sistema Nacional de Cuidados.

Article

MEDICINA Y CIENCIAS DE LA SALUD COVID-19 Nursing Homes Old Age Assistance Instituciones de cuidados a largo plazo Older adults Personas mayores

Propuesta para un plan de acción en envejecimiento y salud

Luis M Gutierrez Robledo MIGUEL ANGEL LEZANA FERNANDEZ (2013)

Uno de los grandes retos que plantea el envejecimiento poblacional es la creciente probabilidad de desarrollar discapacidad y de saturar los sistemas de salud. Está claramente establecido que, en el siglo pasado, la salud pública fue la gran responsable del incremento en la expectativa de vida; para este siglo, la nueva responsabilidad de la salud pública tiene que ampliarse a preservar la calidad de vida y la funcionalidad de todos aquellos a quienes les adiciona años. Por tanto, cualquier política dirigida a los ancianos tiene que estar enfocada a la preservación de la capacidad funcional y de la autonomía, la participación, el cuidado y la autosatisfacción. La salud pública tiene que ir más allá de la prevención y la promoción de la salud, debe enfocarse en el abordaje y el cuidado integrales

Book

MEDICINA Y CIENCIAS DE LA SALUD Geriatrics Geriatría Personas mayores Envejecimiento Aging Older adults Salud publica

Brief Counseling and Exercise Referral Scheme: A Pragmatic Trial in Mexico

KATIA GALLEGOS CARRILLO María del Carmen García Peña JORGE SALMERON CASTRO V. Nelly Salgado de Snyder Felipe Lobelo (2017)

Introduction: The effectiveness of clinical-community linkages for promotion of physical activity (PA) has not been explored in low- and middle-income countries. This study assessed the effectiveness of a primary care-based, 16-week intervention rooted in behavioral theory approaches to increase compliance with aerobic PA recommendations.

Study design: Pragmatic cluster randomized trial.

Setting/participants: Patients had diagnosed (<5 years) hypertension, were aged 35-70 years, self-reported as physically inactive, had a stated intention to engage in PA, and attended Primary Healthcare Centers in the Social Security health system in Cuernavaca, Mexico. Of 23 Primary Healthcare Centers, four were selected based on proximity (5 km radius) to a center.

Intervention: Each center was randomized to a brief PA counseling (BC, n=2) or an exercise referral (ER, n=2) intervention. The study was conducted between 2011 and 2012.

Main outcome measures: Change in objectively measured PA levels (ActiGraph GT3X accelerometers) at baseline, 16, and 24 weeks. Intention-to-treat analyses were used to assess the effectiveness of the intervention overall and according to ER intervention attendance. Longitudinal multilevel mixed-effects analyses considering the interaction (time by intervention) were conducted. Each model was also adjusted by baseline value of the outcome measure, demographic and health variables, social support, PA self-efficacy, and barriers.

Results: Minutes/week of objectively measured moderate to vigorous PA increased by 40 and 53 minutes in the ER and BC groups, respectively (p=0.59). Participants attending >50% of ER program sessions increased their moderate to vigorous PA by 104 minutes/week and compliance with aerobic PA recommendations by 23.8%, versus the BC group (both p<0.05).

Conclusions: Both BC and ER led to modest improvements in PA levels, with no significant differences between groups. Adequate adherence with the ER program sessions led to significant improvements in compliance with aerobic PA recommendations versus BC. These results can help guide development and implementation of programs integrating standardized PA assessment, counseling, and referrals via clinical-community linkages in Mexico and other low- and middle-income countries in the region.

Article

MEDICINA Y CIENCIAS DE LA SALUD Ciencias médicas Ciencias clínicas Geriatría Personas mayores Older adults Ejercicio Exercise Actividad física Physical Activity México Mexico