Gaceta medica de Mexico最新文献

Background: The study of the work and health of older adults is limited but relevant considering that the living and health conditions in which they age are not the best in Mexico, given the job insecurity that does not access to decent contributory pensions.

Objective: To analyse the differences in the sociodemographic, labour and health conditions characteristics of two cohorts of older people aged 65 to 74 years who are employed in the labour market.

Material and methods: Analysis of the National Study of Health and Aging in Mexico for 2001 and 2021 of sociodemographic and work characteristics and health conditions by cohort and sex. Logistic regression models, whose dependent variable was the birth cohort, were estimated.

Results: 1,115 people from 2001 and 1,189 from 2021 between 65 and 74 years old who worked the week before the study were included. By sex and cohort, findings are presented.

Conclusions: Although the schooling of older people in the most recent cohort has increased, women face more precarious working conditions and a higher prevalence of disability.

Background: Aging in Mexico is heterogeneous considering the ethnic diversity and social inequality that prevails. The condition of ethnicity allows us to delve deeper into the social and health inequalities that do not allow for healthy aging.

Objective: The objective of this article is to compare the levels of functionality of older people by ethnicity and its associated factors in Mexico.

Material and methods: People aged 60 years and over were selected from the 2020 Census sample, grouping according to their ethnic status (Indigenous, Afro-Mexican and non-Indigenous and non-afro Mexican). As a dependent variable, the Functional Impairment Index (IDF) was constructed with principal components analysis, using the battery of disability questions; Generalized linear models were performed to analyse the factors associated by ethnicity status.

Results: Indigenous older people have higher IDF values, followed by Afro-Mexican. Indigenous women and those who live in rural areas have higher values of functional impairment.

Conclusions: It is necessary to address the needs of the older Indigenous and Afro-Mexican population who face an old age with greater social disadvantage and functional deterioration.

Background: Information about access to the public health system for elders is lacking in Mexico.

Objective: Develop a cascade of access to the public health system in Mexican older adults and identify factors that could promote or hinder it.

Material and methods: A cross-sectional analysis using data from the 2018, 2021, and 2022 National Health and Nutrition Survey rounds. A cascade of access to the public health system was constructed. Multivariate regression models were performed to identify related factors.

Results: 43.33%, 40.85%, and 43.79% of older adults had access to the public health system in 2018, 2021, and 2022, respectively. In 2018, frailty increased 2.419 times the probability of having access. While, being married or in union, being literate, and living in an urban residency increased access in 2021 and 2022.

Conclusions: There are persistently low levels of public healthcare access among older Mexican adults. Frailty elders had more probability of having access in 2018. Seguro Popular might have promoted access by overcoming organizational obstacles from the public system and surpassing sociodemographic barriers. After its elimination, sociodemographic variables became more relevant in promoting or reducing access.

Background: Aging, urbanization, and lifestyle changes have fueled the non-communicable diseases (NCDs) epidemic.

Objective: Assess mortality, disability, risk factors and life expectancy in people aged ≥60 years (LE-60) in Mexico from 1990-2022 using estimates from the Global Burden of Diseases, Injuries and Risk factors study.

Material and methods: Health loss/gain in terms of disability-adjusted life years, risk factors, LE-60 and healthy life expectancy (HALE-60) by sex and state were analyzed.

Results: NCDs and metabolic risk factors were the main contributors of health loss, noting a high prevalence of non-lethal conditions related to functional decline (vision and hearing), oral conditions, and chronic pain (back pain and osteoarthritis). All-cause mortality and disability rates decreased among men and women while LE-60 and HALE-60 increased from 1990-2022, with state-level variations. States with greater development and healthcare had higher LE-60 and HALE-60.

Conclusions: LE-60 increases were not accompanied by reductions in disability due to functional decline, highlighting the need for healthcare strategies to enhance healthy aging.

Background: Malnutrition is a global problem that affects schoolchildren and can increase the risk of diseases in adulthood. Adult members of the Yaqui Indigenous group have been shown to have serious health problems, and Yaqui schoolchildren could therefore find themselves in a similar situation.

Objective: To evaluate the nutritional status, lipid profile and associated factors in a sample of Yaqui schoolchildren.

Material and methods: A total of 109 Yaqui schoolchildren who lived in their localities of origin were recruited. Anthropometric measurements were carried out, a venous blood sample was extracted in fasting conditions, and several questionnaires were applied.

Results: The prevalence of overweight/obesity was 38.5%, with no cases of chronic malnutrition being recorded; 38.6% of the children had dyslipidemia. Fiber consumption was a protective factor against overweight/obesity, while fat intake was a risk factor. The physical activity score was found to be a protective factor against dyslipidemia, and the risk factors were BMI-for-age Z-scores, waist circumference, family history of dyslipidemia, educational level, and permanent employment.

Conclusions: Yaqui schoolchildren equally suffer from a high proportion of overweight/obesity and dyslipidemia. The associated factors may be useful for the design of contextualized interventions for this population.

Background: The prognosis of patients with ST-segment elevation myocardial infarction (STEMI) and previous percutaneous coronary intervention (PCI) is uncertain.

Objective: To evaluate if previous PCI in patients with STEMI increases the risk of major cardiovascular events, and if final epicardial blood flow differs according to the reperfusion strategy.

Material and methods: Observational, longitudinal, comparative sub-study of the PHASE-MX trial that included patients with STEMI and reperfusion within 12 hours of symptom onset, who were classified according to their history of PCI. The occurrence of the composite primary endpoint (cardiovascular death, re-infarction, congestive heart failure and cardiogenic shock) within 30 days was evaluated using Kaplan-Meier estimates, log-rank test and Cox proportional hazards model. Epicardial blood flow was assessed using the TIMI grading system after reperfusion.

Results: A total of 935 patients were included; 85.6% were males and 6.9% had a history of PCI; 53% underwent pharmacoinvasive therapy, and 47%, primary PCI. The incidence of the composite primary endpoint at 30 days in patients with a history of PCI was 9.8% vs 13.3% in those with no previous PCI (p = 0.06). Among the patients with previous PCI, 87.1% reached a final TIMI grade 3 flow after primary PCI vs. 75% in the group with pharmacoinvasive strategy (p = 0.235).

Conclusions: A history of PCI does not increase the risk of major cardiovascular events at 30 days; however, it impacted negatively on the final angiographic blood flow of patients that received pharmacoinvasive therapy (compared to primary PCI).