Revista Espanola de Geriatria y Gerontologia最新文献

英文中文

Increase in hospital care at the end of life: Retrospective analysis of the last 20 years of life of a cohort of patients 生命末期医院护理的增加：对一组患者生命最后 20 年的回顾性分析

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-03-28 DOI: 10.1016/j.regg.2024.101484

Alberto Jiménez-Puente , María Dolores Martín-Escalante , Francisco Martos-Pérez , Javier García-Alegría

Background

There is an increasing need for end-of-life care due to society's progressive aging. This study aimed to describe how hospitalizations evolve long-term and in the last months life of a cohort of deceased patients.

Methods

The study population were those who died in one year who lived in a district in southern Spain. The number of hospital stays over the previous 20 years and number of contacts with the emergency department, hospitalization, outpatient clinics, and medical day hospital in the last three months of life were determined. The analyses were stratified by age, sex, and pattern of functional decline.

Results

The study population included 1773 patients (82.5% of all who died in the district). The hospital stays during the last 20 years of life were concentrated in the last five years (66%) and specially in the last six months (32%). Eighty percent had contact with the hospital during their last three months of life. The older group had the minimun of stays over the last 20 years and contacts with the hospital in the last months of life.

Conclusions

The majority of hospitalizations occur at the end of life and these admissions represent a significant part of an acute-care hospital's activity. The progressive prolongation of life does not have to go necessarily along with a proportional increase in hospital stays.

背景由于社会逐渐老龄化，人们对临终关怀的需求越来越大。本研究旨在描述一组已故患者在生命最后几个月的长期住院情况。方法研究对象为居住在西班牙南部某地区一年内死亡的患者。研究人员确定了患者在过去 20 年中的住院次数，以及在生命最后三个月中与急诊科、住院部、门诊部和日间医疗医院的联系次数。分析按年龄、性别和功能衰退模式进行了分层。研究对象包括 1773 名患者（占该地区死亡患者总数的 82.5%）。生命最后 20 年的住院时间集中在最后 5 年（66%），尤其是最后 6 个月（32%）。80%的人在生命的最后三个月曾与医院有过接触。结论：大多数住院治疗都发生在生命的最后阶段，这些住院治疗占急症医院活动的很大一部分。生命的逐渐延长并不一定伴随着住院时间的相应增加。

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引用次数: 0

Correlación entre la actividad física y la sintomatología depresiva en centros integrales del adulto mayor de Lima, Perú 秘鲁利马老年人综合中心的体育活动与抑郁症状之间的相关性。

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-03-21 DOI: 10.1016/j.regg.2024.101489

Lizardo Damian Mija Chavez, Luis Enrique López Berrocal, Alvaro Del Carpio Coya, César Gutiérrez Villafuerte

Background and objective

Depression in the elderly is a growing problem, and exercise is a strategy to prevent it. We aim to identify the correlation between scores obtained in the Geriatric Depression Scale - 15 items (GDS-15) for depressive symptomatology and Metabolic equivalent of task (MET) obtained in the International Physical Activity Questionnaire - Short Form (IPAQ-S) for physical activity in aged attending senior centers in a district of Lima, Peru.

Methods

We conducted a cross-sectional study in three senior centers in Miraflores, Lima, Peru. Participants (n = 158) completed a three-part questionnaire, including a sociodemographic survey to collect general participant data, the GDS-15 to assess the level of depressive symptomatology, and the IPAQ-S to evaluate the amount of physical activity performed in the last week.

Results

A mild but significant inverse linear correlation was identified between the GDS-15 score and METs obtained in the IPAQ-S (rho = -0.213, p = 0.007). Moderate to severe depressive symptomatology decreased with a higher level of physical activity: 4.3% low level, 3.3% moderate level, and no cases in those with vigorous activity; however, these differences were not significant (p = 0.541, Kendall's Tau B test).

Conclusión

The results showed that individuals with moderate to severe depressive symptoms show a lower level of depressive symptoms in relation to the degree of physical activity carried out in the last week.

背景和目的老年人抑郁症是一个日益严重的问题，而运动是预防抑郁症的一种策略。我们旨在确定老年抑郁量表--15 个项目（GDS-15）中抑郁症状的得分与国际体育活动问卷--简表（IPAQ-S）中参加秘鲁利马地区老年中心的老年人体育活动的代谢当量（MET）之间的相关性。参与者（n = 158）填写了一份由三部分组成的问卷，包括收集参与者一般数据的社会人口调查、评估抑郁症状程度的 GDS-15 和评估上周体育活动量的 IPAQ-S。中度至重度抑郁症状随着运动量的增加而减少：低度抑郁症状占 4.3%，中度抑郁症状占 3.3%，而剧烈运动者中没有抑郁症状；然而，这些差异并不显著（P = 0.541，Kendall's Tau B 检验）。

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引用次数: 0

Dominios operativos del envejecimiento saludable: una descripción cualitativa en personas adultas mayores de Perú 健康老龄化的操作领域：秘鲁老年人的定性描述

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-03-21 DOI: 10.1016/j.regg.2024.101485

Julio Domínguez-Vergara , Henry Santa-Cruz-Espinoza , Gina Noemí Torres-Villanueva , Eduardo Franco Cabos Zelada

Background and objective

Understanding the domains of healthy aging (HA) through the perceptions of older adults is important for the multidimensional determination of the construct according to the culture of Peru and for the development of plans that promote the health, well-being, resources and strengths of older adults. The purpose of this study is to qualitatively explore the operational domains of HA in Peruvian older adults.

Method

The approach adopted was fundamental qualitative descriptive. A purposive sampling was used and 26 participants attending senior centers belonging to the municipal commune of Lima were recruited (Medad = 67.9; SD = 6.64). Semi-structured interviews were conducted and the content analysis was carried out using an inductive method identifying the units of meaning of the HA.

Results

The content analysis showed 11 sub-themes and 4 main themes. The identified themes were as follows: “functional health”, “psychological well-being”, “active engagement with life” and “religion”. Given this, the results demonstrate the multidimensionality of HA in Peruvian older adults.

Conclusion

The operational domains of HA indicate the importance of individual perceptions considering functional health, psychological well-being, active engagement with life, and religion. This perspective supports the multidimensional concept of HA. This can be implemented as a guide for government entities working with PAMs. In addition, to formulate new public policies focusing on the domains of HA.

背景和目的通过老年人的看法来了解健康老龄化（HA）的各个领域，对于根据秘鲁文化多维度地确定健康老龄化的概念以及制定促进老年人健康、福祉、资源和力量的计划非常重要。本研究的目的是对秘鲁老年人的医管局运作领域进行定性探索。采用目的性抽样，招募了 26 名利马市市镇老年中心的参与者（Medad = 67.9；SD = 6.64）。进行了半结构式访谈，并采用归纳法进行了内容分析，确定了医管局的意义单位。结果内容分析显示了 11 个次主题和 4 个主主题。确定的主题如下"功能性健康"、"心理健康"、"积极参与生活 "和 "宗教"。结论 HA 的操作领域表明，考虑到功能性健康、心理健康、积极参与生活和宗教，个人感知非常重要。这一观点支持 HA 的多维概念。这可以作为政府机构与老年保健机构合作的指南。此外，还可以制定新的公共政策，重点关注医管局的各个领域。

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引用次数: 0

Estado cognitivo, emocional y nivel de dependencia en personas adultas y mayores institucionalizadas 被安置在养老院的成年人和老年人的认知和情绪状态以及依赖程度。

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-28 DOI: 10.1016/j.regg.2024.101481

María Herrero Teijón , Armando González-Sánchez , Lizbeth de la Torre , Antonio Sánchez Cabaco

Introduction

It is necessary to analyze the aging process in institutionalized older people. For this purpose, a descriptive and analytical epidemiological study was carried out in nursing homes for older adults before the COVID-19 pandemic.

Objective

Provide an in-depth insight into cognitive (MEC), emotional (Geriatric Depression Scale), and functional (Barthel Scale) status within the older adult participants.

Method

A sample of 973 participants analyzed the relationship between cognitive status, vulnerability to depression, and autonomous performance in Daily Day Activities (DDA) to predict the impact of the comorbidity of these variables. Therefore, in addition to the general distribution of the sample in the previously mentioned dimensions, differences were analyzed according to gender, age, educational level, and geographic area.

Results

The results confirm the hypothesis that a more impaired cognitive state is associated with higher levels of depression and lower functional capacity. The MEC scores have positive and highly significant correlations with Barthel and Yesavage. The relationship between dementia and autonomy is observed for both sexes, while the relationship between dementia and depression is only observed in women. The educational level influences the MEC scores (the more education, the better performance) and the Barthel scores (the less education, the greater dependency). Statistically significant differences were also found depending on the area of residence location.

Conclusions

The more deteriorated cognitive state will be associated with a higher level of depression and lower functional capacity in daily life activities.

导言：有必要对养老院老年人的衰老过程进行分析。为此，我们在 COVID-19 大流行之前，在老年人疗养院中开展了一项描述性和分析性流行病学研究。方法对 973 名参与者的样本进行分析，研究认知状态、易患抑郁症的程度以及在日常活动（DDA）中的自主表现之间的关系，以预测这些变量的合并影响。因此，除了分析样本在上述维度上的总体分布情况外，还根据性别、年龄、教育水平和地理区域分析了差异。MEC 评分与 Barthel 和 Yesavage 呈高度显著的正相关。痴呆症与自理能力之间的关系在男女中均可观察到，而痴呆症与抑郁之间的关系仅在女性中观察到。教育水平会影响 MEC 分数（教育程度越高，表现越好）和 Barthel 分数（教育程度越低，依赖性越强）。结论认知状态越差，抑郁程度越高，日常生活能力越低。

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引用次数: 0

Investigation of the adaptation of older adults to online learning and artificial intelligence 调查老年人对在线学习和人工智能的适应情况

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-28 DOI: 10.1016/j.regg.2024.101477

Elif Gur Kabul , Bilge Basakci Calik , Nadir Tayfun Ozcan , Suleyman Gursoy

Purpose

The purpose of this study was to investigate the adaptation of older adults, to online learning and artificial intelligence.

Material and methods

210 older adults (109 women; 101 men) aged 65 and over, were included. Hodkinson Mental Test, Online Learning Readiness Scale (OLRS) and Artificial Intelligence Anxiety Scale (AIAS) were used in evaluation. Older adults with 6 score and above in Hodkinson Mental Test, in which their cognitive level was evaluated, were included. Older adults were stratified according to their gender and age (Group I: 65–70 years; Group II: 71–75 years; Group III: 76 years and over).

Results

In comparison analysis between age groups, there was a significant difference in the total score and all subdimensions of OLRS in favor of Group I (p < 0.05), and in the total score and all subdimensions of AIAS (p < 0.05). When analyzed according to gender, “The computer/Internet self-efficacy” subdimension of OLRS was significantly higher in male older adults (p < 0.05). “Learning” subdimension of AIAS was significantly higher in female older adults (p < 0.05).

Conclusion

With increasing age in older adults, the readiness for online learning decreases and the level of artificial intelligence anxiety increases. There is no difference between male and female older adults in the readiness for online learning and artificial intelligence anxiety levels, and it is moderate in both genders. In this context, we think that information about online and artificial intelligence applications for older adults would be beneficial.

材料和方法 210 名 65 岁及以上的老年人（109 名女性；101 名男性）被纳入研究。评估采用霍奇金森心理测试、在线学习准备量表（OLRS）和人工智能焦虑量表（AIAS）。评估认知水平的霍奇金森智力测验得分在 6 分及以上的老年人被纳入评估范围。根据性别和年龄对老年人进行了分层（第一组：65-70 岁；第二组：71-75 岁；第三组：76 岁及以上）。结果在年龄组之间的比较分析中，第一组在 OLRS 的总分和所有分项上都有显著差异（P <0.05），在 AIAS 的总分和所有分项上也有显著差异（P <0.05）。根据性别进行分析，男性老年人的 OLRS "计算机/互联网自我效能感 "子维度明显更高（p <0.05）。"结论随着年龄的增长，老年人在线学习的准备程度降低，人工智能焦虑程度增加。男性和女性老年人在在线学习准备度和人工智能焦虑水平上没有差异，且在两性中都处于中等水平。在这种情况下，我们认为为老年人提供有关在线学习和人工智能应用的信息将是有益的。

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引用次数: 0

Test Alusti como variable premonitoria de procesos adversos de salud en una residencia de mayores. Seguimiento a 2 años 作为养老院不良健康事件预测因子的奥卢斯提试验。两年随访

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-27 DOI: 10.1016/j.regg.2024.101476

Olga Bueno Yáñez , Juan José Calvo Aguirre , Joana Uranga Zaldua , Josu Alustiza Navarro , Maider Ugartemendia Yerobi

Introduction

Functional capacity is a good indicator of health, quality of life, and a good predictor of morbimortality. It is a priority to functionally assess the geriatric population through objective, precise, and simple instruments. The Alusti Test in its two versions, complete (TA) and abbreviated (TAA), is a scale that meets these criteria.

Objective

To determine the usefulness of the Alusti Test as a predictor of adverse health events: falls, hospitalizations, cognitive deterioration, and mortality in the elderly institutionalized population, with a two-year follow-up.

Material and methods

This observational study's sample included 176 persons admitted to a nursing home for 32 months, with a mean age of 85.5 years. The TA was performed on 138 and the TAA on 38.

Results

The ratio of falls is much higher in residents with mild dependence than in those with total dependence (P < .001). Hospitalizations increase as the results of the Alusti Test are more favorable. The risk of hospitalization in dependent patients is 50% lower (P < .001) than in those with preserved mobility. Cognitive impairment is similar in all the populations with some mild-moderate level of functional dependence and decreases in the population with preserved mobility. Categorization as total and mild/severe dependence is related to a 3-4 times higher mortality at six months follow-up.

Conclusions

A higher mild-moderate level of dependence on the AT correlates with a lower risk of falls, a lower rate of hospitalization, and a higher risk of mortality at six months.

导言功能是健康和生活质量的良好指标，也是预测死亡率的良好指标。通过客观、精确和简单的工具对老年人群进行功能评估是当务之急。阿鲁斯提测试有两种版本，即完整版（TA）和简略版（TAA），是一种符合上述标准的量表。目标确定阿鲁斯提测试作为不良健康事件（跌倒、住院、认知功能衰退和死亡率）预测指标的实用性，并对养老院老年人群进行为期两年的随访。结果轻度依赖者的跌倒比例远高于完全依赖者（P < .001）。阿鲁斯蒂测试结果越好，住院率越高。依赖型患者的住院风险比行动能力保持良好的患者低 50%（P < .001）。所有轻度-中度功能依赖患者的认知障碍程度相似，而活动能力保持良好的患者的认知障碍程度则有所下降。结论对辅助呼吸系统的轻度-中度依赖程度越高，跌倒风险越低，住院率越低，六个月后的死亡率越高。

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引用次数: 0

Millennials y generación Z: intentando retener el talento de los nuevos geriatras. Un reto compartido... y competido 千禧一代和 Z 世代：努力留住新老年医学人才。共同的挑战......也是竞争的挑战

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-24 DOI: 10.1016/j.regg.2024.101480

Daniel Rosselló-Jiméne, Sami Loutfi, Mireia Llonch-Masriera

引用次数: 0

Estereotipos negativos de la vejez en los nuevos médicos internos residentes 新来的医学实习生对老年的负面成见

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-24 DOI: 10.1016/j.regg.2024.101478

Santiago Cotobal Rodeles , Francisco Javier Martín Sánchez , Manuel Martínez-Selles

Objectives

To determine the presence of negative stereotypes of old age in new medical intern residents (MIR) of the Community of Madrid.

Material and methods

A descriptive cross-sectional survey study of first year MIRs was carried out anonymously during the process of registration at the Madrid College of Physicians between 25/03 and 26/05 of 2023. The Questionnaire of Negative Stereotypes towards Old Age (CENVE) and the Let's Fight All Together Against Ageism (LTJCE) survey were used.

Results

A total of 829 new MIRs were included, with a mean age of 26.0 (standard deviation [SD] = 3.5) years. According to the LTJCE survey, 29.1% consider that in general older people are similar to each other; 47.5%, that deterioration of health in old age is inevitable, 26.8% that old age begins at 60 years; 30.5%, that age per se is a determinant when making clinical decisions and 31.0%, that aging is an obstacle that we must overcome in order to lead a healthy life. The mean total score of the CENVE scale (range 15-60) was 28.3 (SD = 7.0) and the means of the different factors (range 5-20) were 8.6 (SD = 2.8) for health; 9.8 (SD = 2.6) for motivational-social; 10.0 (SD = 2.7) for character-personality.

Conclusions

Most new MIRs do not present old age-related stereotypes.

材料与方法 2023 年 3 月 25 日至 5 月 26 日，在马德里医学院注册过程中，以匿名方式对一年级医学实习生进行了描述性横断面调查研究。调查采用了 "对老年人的负面成见问卷"（CENVE）和 "让我们共同反对老龄歧视"（LTJCE）调查。结果共纳入了 829 名新入学的医学住院医生，他们的平均年龄为 26.0 岁（标准差 [SD] = 3.5）。根据 LTJCE 调查，29.1% 的人认为老年人在总体上是相似的；47.5% 的人认为老年人健康状况的恶化是不可避免的；26.8% 的人认为老年期从 60 岁开始；30.5% 的人认为年龄本身是临床决策的决定因素；31.0% 的人认为衰老是我们必须克服的障碍，以便过上健康的生活。CENVE 量表的平均总分（范围 15-60）为 28.3（标准差 = 7.0），不同因素（范围 5-20）的平均值分别为：健康 8.6（标准差 = 2.8）；动机-社会 9.8（标准差 = 2.6）；性格-人格 10.0（标准差 = 2.7）。

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引用次数: 0

The COVID-19 Vaccine Gamble—By luck they worked in the oldest, frailest people COVID-19 疫苗赌博--幸运的是，它们在最年老体弱的人群中起了作用

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-02-24 DOI: 10.1016/j.regg.2023.101427

Roy L. Soiza , Megan Niven

引用次数: 0

¿Conocen los pacientes con insuficiencia cardiaca avanzada las características y el pronóstico de su enfermedad? 晚期心力衰竭患者了解自己疾病的特点和预后吗？

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2024-01-20 DOI: 10.1016/j.regg.2023.101456

Anna Contra, Lourdes Garcia, Paula Pons, Francesc Formiga

引用次数: 0

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