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Translating lessons from immortal models: Hydra and the immortal jellyfish
Q3 Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.regg.2025.101624
Cristina Mas-Bargues
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引用次数: 0
Papel y función del apoyo social en los post-cuidadores familiares de personas mayores dependientes [社会支持在受抚养人家庭后照顾者中的作用和功能]。
Q3 Medicine Pub Date : 2025-01-16 DOI: 10.1016/j.regg.2024.101612
María Camila Parra Ortiz , Ana Belén Navarro Prados , María Cruz Sánchez Gómez , Juan Luis Cabanillas García

Introduction and objective

Social support appears to have a positive impact on the mental health and well-being of post-caregivers. Therefore, the aim of this paper is to examine the perceived social support network and its role in post-caregiving.

Materials and methods

56 family post-caregivers of older people participated in a semi-structured interview. In addition, the Social Support Questionnaire -MOS- and qualitative measures were applied. Descriptive analyses of the relationship between variables were carried out. At the qualitative level, we worked with a phenomenological design using the NVIVO program. Finally, data were triangulated using the mixed concurrent triangulation design methodology (DITRIAC).

Results

Post-care adjustment was positively associated with the dimensions of the perceived social support scale. The network of friends was found to be supportive during the loss, generating spaces for leisure and recreation that allowed post-caregivers to resume their social life. The family unit can move closer or further away. Children played a role of support and companionship for the post-caregivers and are also a source of motivation to cope and adapt to the loss of the cared-for relative. Participants emph
asised the need to feel listened to and welcomed. 64.3% of participants referred to not having received psychological care.

Conclusions

It is essential to carry out interventions that favor the development and maintenance of the family caregiver.
前言和目的:社会支持似乎对后照顾者的心理健康和福祉有积极影响。因此,本研究的目的是研究感知社会支持网络及其在护理后的作用。材料与方法:对56名老年人家庭后照顾者进行半结构化访谈。此外,还采用了社会支持问卷(mos)和定性测量。对变量之间的关系进行了描述性分析。在定性层面,我们使用NVIVO程序进行现象学设计。最后,使用混合并发三角剖分设计方法(DITRIAC)对数据进行三角剖分。结果:护理后适应与感知社会支持量表各维度呈正相关。研究发现,在失去亲人期间,朋友圈会给予他们支持,创造出休闲和娱乐的空间,让失去照顾者的人能够恢复他们的社交生活。家庭单位可以移动得更近或更远。儿童对失去照顾者的人起到了支持和陪伴的作用,也是应对和适应失去照顾者亲人的动力来源。与会者强调需要感到被倾听和受欢迎。64.3%的参与者表示没有接受过心理治疗。结论:实施有利于家庭照顾者发展和维持的干预措施是必要的。
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引用次数: 0
Factors associated with sarcopenia in a population of non-disabled older patients 非残疾老年患者人群中与肌肉减少症相关的因素
Q3 Medicine Pub Date : 2025-01-16 DOI: 10.1016/j.regg.2024.101608
Gloria Gabriela Peña Ordóñez , Lilia Patricia Bustamante Montes , José de Jesús Garduño García , Gabriel Gerardo Huitrón Bravo , Paola Conde Higuera , Alfonso J. Cruz-Jentoft

Background and aim

To evaluate the association between sarcopenia and metabolic syndrome.

Patients and methods

A case–control study. Setting. Geriatric Care Clinic of Metepec (México). Inclusion criteria. Outpatients with physical and mental independence to perform daily living activities (DLA). Exclusion criteria. Physical or mental disability requiring assistance from a carer, active cancer, cardiopathies and renal disease.

Patients

124 participants (59.6% women) aged over 60 years (mean age 69.7 years, standard deviation ± 6.5 years).

Measurements

62 with sarcopenia according to the EGWSOP 2019 definition. Hypertension, diabetes, adiposity and dyslipidaemia were assessed, and the prevalence and odds ratio (OR) of metabolic syndrome in cases and controls were calculated.

Results

Participants with sarcopenia were more likely to be female (80% vs. 41.8%), with no major differences from controls in other characteristics. 46.7% of participants were obese and 25.8% in both groups met diagnostic criteria for the metabolic syndrome; of the items defining the metabolic syndrome, only hypertension, obesity grade II and central obesity were associated with the presence of sarcopenia (OR 2.12; 3.39 and 1.93, respectively, with 95% CI).

Conclusions

We could not confirm an association between sarcopenia and the metabolic syndrome, but with the obesity and hypertension components.
背景与目的:探讨肌肉减少症与代谢综合征的关系。患者和方法:病例对照研究。地点:梅特佩克老年保健诊所。纳入标准:门诊患者身心独立进行日常生活活动(DLA)。排除标准:需要照顾者帮助的身体或精神残疾、活动性癌症、心脏病和肾脏疾病。患者:124例(59.6%为女性),年龄大于60岁(平均年龄69.7岁,标准差±6.5岁)。测量结果:根据EGWSOP 2019的定义,62例患有肌肉减少症。评估高血压、糖尿病、肥胖和血脂异常,计算病例和对照组中代谢综合征的患病率和比值比(OR)。结果:患有肌肉减少症的参与者更有可能是女性(80%对41.8%),在其他特征上与对照组没有重大差异。46.7%的参与者肥胖,两组中25.8%符合代谢综合征的诊断标准;在定义代谢综合征的项目中,只有高血压、肥胖II级和中心性肥胖与肌肉减少症的存在相关(OR 2.12;分别为3.39和1.93,95% CI)。结论:我们不能证实肌肉减少症与代谢综合征之间的联系,但与肥胖和高血压成分有关。
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引用次数: 0
Very old patients in the ICU in Latin America: A narrative review 拉丁美洲重症监护病房的高龄病人:叙述性回顾。
Q3 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.regg.2024.101560
Andrés Giglio , Javiera Barrientos , Andrés Ferre , Felipe Salech
The population of very elderly patients (aged 80 years and older) in intensive care units (ICUs) is steadily growing. These patients have unique physiological, cognitive, functional, and social characteristics that affect their entire ICU course. Immobility, delirium, dysphagia, malnutrition, and polypharmacy are among the most common geriatric syndromes in these patients, and they contribute to a higher risk of acute and long-term functional decline and mortality. Risk assessment in very elderly patients is complex, as traditional ICU scoring systems do not account for frailty and baseline disability, making difficult the determination of likely benefits, futility, or harm with ICU interventions. The importance of shared decision-making for treatment plans is critical, as very elderly patients and their families may have uncertain or unrealistic prognostic awareness and expectations of ICU care. Considering the gap between the rapid aging of the population and the socio-health development in Latin America, this population is an important determinant of stress on healthcare systems, however, data on these population is scarce. This review, based on a comprehensive literature search, summarizes recent evidence on triage for ICU admission, specific clinical characteristics, predictive elements of prognosis, and ICU and post-ICU outcomes for very elderly patients while also analyzing the challenges to improve management in the Latin American region.
重症监护病房(icu)的高龄患者(80岁及以上)人数正在稳步增长。这些患者具有独特的生理、认知、功能和社会特征,影响其整个ICU病程。行动不便、谵妄、吞咽困难、营养不良和多种药物是这些患者中最常见的老年综合征,它们导致急性和长期功能下降和死亡的风险更高。高龄患者的风险评估是复杂的,因为传统的ICU评分系统不考虑虚弱和基线残疾,使得难以确定ICU干预可能的益处、徒劳或危害。共同决策治疗方案的重要性是至关重要的,因为高龄患者及其家属可能对ICU护理有不确定或不现实的预后意识和期望。考虑到拉丁美洲人口快速老龄化与社会卫生发展之间的差距,这一人口是卫生保健系统压力的重要决定因素,然而,关于这些人口的数据很少。本综述基于全面的文献检索,总结了最近关于ICU入院分诊、特定临床特征、预后预测因素、高龄患者ICU和ICU后预后的证据,同时分析了拉丁美洲地区改善管理的挑战。
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引用次数: 0
Exploring factors influencing delirium incidence: Insights from the Alzira cohort study, 2012–2021 探索影响谵妄发病率的因素:来自2012-2021年Alzira队列研究的见解。
Q3 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.regg.2024.101571
Daniela Villalón-Rubio , Elisa García-Tercero , Jesús López-Gómez , Hugo González , Ángel Belenguer-Varea , Cristina Cunha-Pérez , Miguel Germán Borda , Francisco José Tarazona-Santabalbina

Introduction

Hip fractures are a common pathology among older adults, often accompanied by significant complications such as delirium, a geriatric syndrome associated with prolonged hospitalization, reduced functional recovery, and decreased overall survival rates. This study aims to determine the incidence of delirium and its correlation with various factors during hospitalization, as well as its impact on short-, medium-, and long-term survival.

Methodology

A retrospective cohort study was undertaken to examine hospital admissions of individuals aged 70 years or older diagnosed with hip fractures at the Hospital Universitario La Ribera in Alzira, Valencia, from January 2012 to December 2021.

Results

A total of 3226 patients were recruited, mean of 85 years, 73.7% females, 26.3% males. Delirium was observed in 10.9% of patients during hospitalization (68.8% females, p = 0.029). Patients diagnosed with delirium exhibited a greater prevalence of dementia (25.2%, p < 0.001) and chronic kidney disease (14.7%, p = 0.018). Delirium was also significantly associated with older age (mean 86.5 years [SD 5.6], p < 0.001), increased number of complications (mean 1.4 [SD 1.6], p < 0.001), cardiac complications (9.1%, p = 0.036), anemia (21.7%, p < 0.001), and urinary tract infections (7.4%, p < 0.001) during hospitalization. Furthermore, patients with delirium experienced a prolonged hospital stay (mean 9 vs. 7.9 days, p < 0.001) and significantly higher short-, medium-, and long-term mortality rates.

Discussion

The study findings underscore a significant association between delirium and comorbidities, complications, and mortality. Early identification of patients at risk for delirium will allow us to implement targeted interventions focused on prevention to enhance patient outcomes.
髋部骨折在老年人中是一种常见的病理,通常伴有明显的并发症,如谵妄,这是一种与住院时间延长、功能恢复减少和总生存率降低相关的老年综合征。本研究旨在了解谵妄的发生率及其与住院期间各因素的相关性,以及谵妄对患者短、中、长期生存的影响。方法:2012年1月至2021年12月,在瓦伦西亚Alzira的La Ribera大学医院进行了一项回顾性队列研究,检查了70岁及以上诊断为髋部骨折的住院患者。结果:共纳入3226例患者,平均85岁,女性73.7%,男性26.3%。住院期间谵妄发生率为10.9%,其中女性为68.8%,p=0.029。诊断为谵妄的患者表现出更高的痴呆患病率(25.2%)。讨论:研究结果强调了谵妄与合并症、并发症和死亡率之间的显著关联。早期识别有谵妄风险的患者将使我们能够实施有针对性的干预措施,重点是预防,以提高患者的预后。
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引用次数: 0
Optimización del cuidado crítico en adultos mayores en la UCI [ICU老年人重症监护优化]。
Q3 Medicine Pub Date : 2025-01-01 DOI: 10.1016/j.regg.2024.101576
Javier Martínez-Peromingo, Myriam Rodríguez-Couso
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引用次数: 0
Condiciones de salud bucodental y estados nutricionales, funcionales y cognitivos: una aproximación al adulto mayor institucionalizado [口腔健康状况与营养、功能和认知状况——一种针对住院老年人的方法]。
Q3 Medicine Pub Date : 2024-12-28 DOI: 10.1016/j.regg.2024.101618
Neil Duván Gutiérrez, Jorge Andrés Sosa galindo, Diego Camilo Yarpaz, Valentina Urbano, Juan Fernando Jiménez, Jhoan León, María Teresa Calzada, Raúl Guevara, Bruno Gutiérrez

Introduction/objective

Multidimensional geriatric assessment is an important diagnostic method in geriatrics. The objective of this article was to establish the relationship between nutritional, functional, cognitive status and oral health of institutionalized older adults.

Methodology

A cross-sectional observational study was carried out, where 93 institutionalized older adults participated, including oral assessment and Barthel, Minimental, Mininutritional and Yesavage scales. An univariate, bivariate and multivariate analysis was performed at 2 care sites in the city of Cali, Colombia.

Results

Mean age of the participants was 76.5 years; more than 50% with null or primary educational levels, 23% presented limitation in mobility, arterial hypertension was the most prevalent pathological history with 55%, followed by diabetes mellitus 24%; and 60% of the sample was independent to perform basic activities (Barthel index = 100). Regarding the number of occlusal pairs prosthesis to prosthesis, it was found that the mean of men was lower than women (2.4 and 5.2, P = 0.03). The results showed an altered plaque indicator in patients with cognitive impairment 61.5% versus 100% in patients with dementia screening. Additionally, a number of teeth less than 20 in people with depression indicators in 79.2%. The multivariate analysis showed a relationship with partial or total edentulism, being the total a risk for depressive traits (P = 0.04).

Conclusion

The results show that nutritional, functional, cognitive aspects and depression traits are related to oral health. In addition, it should be noted that a significant proportion of patients require dental intervention.
前言/目的:多维老年评估是老年医学诊断的重要手段。本文的目的是建立营养、功能、认知状况与老年人口腔健康之间的关系。方法:进行了一项横断面观察性研究,共有93名机构老年人参与,包括口头评估和Barthel, Minimental, minnutritional和Yesavage量表。在哥伦比亚卡利市的2个医疗点进行了单因素、双因素和多因素分析。结果:参与者平均年龄76.5岁;50%以上的患者文化程度为零或小学,23%的患者活动能力受限,动脉高血压是最常见的病理史,占55%,其次是糖尿病,占24%;60%的样本能够独立进行基本活动(Barthel指数=100)。在义肢对义肢的咬合对数方面,男性的平均值低于女性(2.4对和5.2对,P=0.03)。结果显示,认知障碍患者的斑块指标改变了61.5%,而痴呆筛查患者的斑块指标改变了100%。此外,牙齿少于20颗的人数在抑郁症患者中占79.2%。多变量分析显示,部分或全牙槽齿与抑郁特征的总风险相关(P=0.04)。结论:营养、功能、认知和抑郁特征与口腔健康有关。此外,应该注意的是,相当比例的患者需要牙科干预。
{"title":"Condiciones de salud bucodental y estados nutricionales, funcionales y cognitivos: una aproximación al adulto mayor institucionalizado","authors":"Neil Duván Gutiérrez,&nbsp;Jorge Andrés Sosa galindo,&nbsp;Diego Camilo Yarpaz,&nbsp;Valentina Urbano,&nbsp;Juan Fernando Jiménez,&nbsp;Jhoan León,&nbsp;María Teresa Calzada,&nbsp;Raúl Guevara,&nbsp;Bruno Gutiérrez","doi":"10.1016/j.regg.2024.101618","DOIUrl":"10.1016/j.regg.2024.101618","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>Multidimensional geriatric assessment is an important diagnostic method in geriatrics. The objective of this article was to establish the relationship between nutritional, functional, cognitive status and oral health of institutionalized older adults.</div></div><div><h3>Methodology</h3><div>A cross-sectional observational study was carried out, where 93 institutionalized older adults participated, including oral assessment and Barthel, Minimental, Mininutritional and Yesavage scales. An univariate, bivariate and multivariate analysis was performed at 2<!--> <!-->care sites in the city of Cali, Colombia.</div></div><div><h3>Results</h3><div>Mean age of the participants was 76.5 years; more than 50% with null or primary educational levels, 23% presented limitation in mobility, arterial hypertension was the most prevalent pathological history with 55%, followed by diabetes mellitus 24%; and 60% of the sample was independent to perform basic activities (Barthel index<!--> <!-->=<!--> <!-->100). Regarding the number of occlusal pairs prosthesis to prosthesis, it was found that the mean of men was lower than women (2.4 and 5.2, <em>P</em> <!-->=<!--> <!-->0.03). The results showed an altered plaque indicator in patients with cognitive impairment 61.5% versus 100% in patients with dementia screening. Additionally, a number of teeth less than 20 in people with depression indicators in 79.2%. The multivariate analysis showed a relationship with partial or total edentulism, being the total a risk for depressive traits (<em>P</em> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusion</h3><div>The results show that nutritional, functional, cognitive aspects and depression traits are related to oral health. In addition, it should be noted that a significant proportion of patients require dental intervention.</div></div>","PeriodicalId":39958,"journal":{"name":"Revista Espanola de Geriatria y Gerontologia","volume":"60 3","pages":"Article 101618"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Traducción y validación de la Escala clínica de fragilidad (ECF) al español en Chile [临床虚弱量表(CFS)在智利的西班牙语翻译和验证]。
Q3 Medicine Pub Date : 2024-12-27 DOI: 10.1016/j.regg.2024.101619
Jorge Browne , Paola Balcázar , Josefa Palacios , Ignacia Sepúlveda , Ingrid Danke , Marcela Carrasco

Introduction

The assessment of frailty is crucial for the management and care of older adults. The Clinical Frailty Scale (CFS) has been proposed as a useful and practical tool for this assessment, but its implementation requires translation and validation to the specific cultural context.

Methods

A standardized process of translation and cultural adaptation of the CFS in its second version was carried out. Then, 44 participants were recruited, including geriatricians and geriatrics residents, who evaluated 11 clinical cases using the scale. The intraclass correlation coefficient (ICC) was used to assess the variability between the evaluators.

Results

A total of 484 evaluations were obtained (11 cases, 44 evaluators) with an intraclass correlation coefficient of 0.98. The sensitivity analysis showed no differences between subgroups of evaluators separated by years of experience or specialty status (certified geriatricians or those in training).

Conclusions

The Spanish version of the CFS is reliable and practical for the assessment of frailty in older adults in Chile, constituting a valuable tool for this purpose in this context.
简介:虚弱的评估对老年人的管理和护理至关重要。临床虚弱量表(CFS)已被提出作为一种有用和实用的评估工具,但其实施需要根据具体的文化背景进行翻译和验证。方法:对CFS第二版进行标准化的翻译和文化改编。然后,招募了44名参与者,包括老年病医师和老年住院医师,他们使用该量表评估了11例临床病例。使用类内相关系数(ICC)来评估评估者之间的可变性。结果:共获得评价484条(11例,44位评价者),类内相关系数为0.98。敏感性分析显示,按经验年限或专业状况(持证老年病医生或接受培训的医生)划分的评估者亚组之间没有差异。结论:西班牙语版的CFS对于评估智利老年人的虚弱是可靠和实用的,在这方面构成了一个有价值的工具。
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引用次数: 0
Eficacia y seguridad del tratamiento de la osteoporosis en el anciano. Propuesta de SEFRAOS para abordaje de la prevención secundaria de fracturas en el adulto mayor 老年人骨质疏松症治疗的有效性和安全性。老年人骨折的二级预防方法。SEFRAOS的提案]。
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101611
Jose Manuel Cancio Trujillo , Bernardo Abel Cedeño Veloz
{"title":"Eficacia y seguridad del tratamiento de la osteoporosis en el anciano. Propuesta de SEFRAOS para abordaje de la prevención secundaria de fracturas en el adulto mayor","authors":"Jose Manuel Cancio Trujillo ,&nbsp;Bernardo Abel Cedeño Veloz","doi":"10.1016/j.regg.2024.101611","DOIUrl":"10.1016/j.regg.2024.101611","url":null,"abstract":"","PeriodicalId":39958,"journal":{"name":"Revista Espanola de Geriatria y Gerontologia","volume":"60 3","pages":"Article 101611"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implantación de un circuito asistencial para la adaptación de la medicación oral en pacientes con disfagia entre atención especializada y atención primaria [在医院和初级保健机构对吞咽困难患者进行药物治疗调整的医疗保健网络的实施]。
Q3 Medicine Pub Date : 2024-12-24 DOI: 10.1016/j.regg.2024.101616
Susana de Andrés Morera , Susana Chajma Izquierdo , Ana Arancón Pardo , Elena Villamañán Bueno
{"title":"Implantación de un circuito asistencial para la adaptación de la medicación oral en pacientes con disfagia entre atención especializada y atención primaria","authors":"Susana de Andrés Morera ,&nbsp;Susana Chajma Izquierdo ,&nbsp;Ana Arancón Pardo ,&nbsp;Elena Villamañán Bueno","doi":"10.1016/j.regg.2024.101616","DOIUrl":"10.1016/j.regg.2024.101616","url":null,"abstract":"","PeriodicalId":39958,"journal":{"name":"Revista Espanola de Geriatria y Gerontologia","volume":"60 3","pages":"Article 101616"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Revista Espanola de Geriatria y Gerontologia
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