Revista Espanola de Geriatria y Gerontologia最新文献_第6页

C-reactive protein predicts functional decline in older adults newly diagnosed with dementia: A 5-year follow-up study c反应蛋白预测新诊断为痴呆的老年人功能下降：一项5年随访研究

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-08-27 DOI: 10.1016/j.regg.2025.101722

Miguel Germán Borda , Tommy Cederholm , Salomón Salazar-Londoño , Luis Carlos Venegas-Sanabria , Hidetaka Wakabayashi , Mario Ulises Pérez-Zepeda , Miguel Fernando Borda , Jonathan Patricio Baldera , Dag Aarsland

Background and objectives

With the increasing prevalence of dementia, identifying markers that predict prognosis in people newly diagnosed with the disease is crucial for developing targeted interventions and initiating early actions to improve their outcomes. On the other hand, C-reactive protein (CRP) is an easily accessible marker of inflammation. This study aims to evaluate whether CRP is a marker of weight loss, cognitive decline, functional decline, and mortality in older adults newly diagnosed with dementia.

Methods

We utilized data from DemVest, a longitudinal cohort study, including participants diagnosed with mild dementia due to Alzheimer's Disease (AD) or Lewy Body Dementia (LBD). CRP levels were measured at diagnosis. Main outcome measures were functional decline, weight, body mass index (BMI), cognitive decline and mortality assessed during a 5-year follow-up period after diagnosis. Demographic and clinical factors were considered as potential confounders, and we performed linear regression models for baseline and linear mixed models for longitudinal analysis.

Results

A total of 158 participants were included, with an average age of 75.2 years (SD 7.65). 60.8% (n = 96) of patients had AD, and 39.2% (n = 62) had LBD. Elevated CRP was associated with functional decline during follow-up (Est 0.0118, p-value < 0.001). For BMI or weight, we did not find any statistically significant associations, as well as for MMSE, and mortality.

Conclusion

Higher CRP levels were associated with greater functional decline in individuals newly diagnosed with dementia.

背景与目的随着痴呆症患病率的增加，在新诊断的痴呆症患者中识别预测预后的标志物对于制定有针对性的干预措施和启动早期行动以改善其预后至关重要。另一方面，c反应蛋白（CRP）是一种容易获得的炎症标志物。本研究旨在评估CRP是否是新诊断为痴呆的老年人体重减轻、认知能力下降、功能下降和死亡率的标志。方法：我们利用了纵向队列研究DemVest的数据，包括被诊断为阿尔茨海默病（AD）或路易体痴呆（LBD）引起的轻度痴呆的参与者。在诊断时测量CRP水平。诊断后5年随访期间评估的主要结局指标为功能下降、体重、体重指数（BMI）、认知能力下降和死亡率。人口统计学和临床因素被认为是潜在的混杂因素，我们对基线进行了线性回归模型，对纵向分析进行了线性混合模型。结果共纳入158例受试者，平均年龄75.2岁（SD 7.65）。60.8% （n = 96）的患者患有AD， 39.2% （n = 62）的患者患有LBD。随访期间，CRP升高与功能下降相关（Est 0.0118， p值<； 0.001）。对于BMI或体重，我们没有发现任何统计学上显著的关联，以及MMSE和死亡率。结论在新诊断为痴呆的个体中，较高的CRP水平与更大的功能下降相关。

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引用次数: 0

Uso racional de antipsicóticos en pacientes mayores: un abordaje cualitativo 老年患者合理使用抗精神病药物：定性方法

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-08-27 DOI: 10.1016/j.regg.2025.101720

María Noelia Vivacqua , María Florencia Grande Ratti , José Luis Faccioli

Background and objective

Antipsychotics are frequently prescribed in elderly patients. The aim of this study was to explore the barriers that hinder their rational use in this population in a hospital in Argentina

Method

A qualitative study based on ten semi-structured individual interviews with doctors from various specialties working in outpatient clinics, conducted between May and November 2022. The focus was on identifying perceptions and practices related to the prescription of antipsychotics in elderly patient populations.

Results

Various difficulties in making rational use of antipsychotics were identified: a) Prescription issues, such as drug selection primarily based on the professional's experience and the tendency to use low doses and short-term treatments without considering the patient's clinical progression; b) underestimation of metabolic side effects in the elderly patient population; c) limitations of the healthcare system, such as difficulty in accessing consultations between psychiatry and other medical specialties, and deficiencies in training; d) patient or family preferences that often conflict with medical recommendations.

Conclusions

Barriers to the rational prescription of antipsychotics in elderly patients were identified, both among psychiatrists and doctors from other specialties. These difficulties could compromise the efficacy and safety of treatment in this vulnerable population. Highlighting this information could help healthcare organizations develop strategies to improve the quality of care.

背景与目的抗精神病药物常用于老年患者。本研究的目的是探讨妨碍阿根廷某医院这一人群合理使用药物的障碍。这是一项定性研究，基于对门诊诊所各专业医生的10次半结构化个人访谈，于2022年5月至11月期间进行。重点是确定老年患者人群中与抗精神病药物处方有关的认知和做法。结果指出了合理使用抗精神病药物的各种困难：a)处方问题，如主要根据专业人员的经验选择药物，倾向于使用低剂量和短期治疗，而不考虑患者的临床进展；B)低估老年患者人群的代谢副作用；C)卫生保健系统的局限性，例如难以获得精神病学和其他医学专业之间的会诊，以及培训不足；D)患者或家庭的偏好经常与医疗建议相冲突。结论老年患者合理开具抗精神病药物处方存在障碍，包括精神科医生和其他专科医生。这些困难可能会影响这一脆弱人群治疗的有效性和安全性。突出显示这些信息可以帮助医疗保健组织制定提高护理质量的策略。

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引用次数: 0

Síndrome de platipnea-ortodeoxia en neumonía bilateral por SARS-CoV-2: una entidad clínica emergente e infradiagnosticada. A propósito de un caso SARS-CoV-2双侧肺炎中的斑块-正氧综合征：一种新兴的、失放射化的临床实体。关于一个案例

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-08-27 DOI: 10.1016/j.regg.2025.101719

José Luis Esquinas Requena, Georgina Martinón Torres, María Teresa Madrid López, Cristina de la Rubia Molina, Rocío Onieva Albañil

引用次数: 0

Elaboración y validación del cuestionario Modelo de Atención Gerontológica (MAGE) para profesionales, residentes y familiares, para la evaluación de la implantación de la atención gerontológica centrada en la persona en centros residenciales 为专业人员、居民和家庭成员编制和验证老年护理标准问卷，以评估在住宅中心实施以人为本的老年护理的情况

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-08-27 DOI: 10.1016/j.regg.2025.101716

Nerea Suárez Pérez de Eulate

Objective

To develop an instrument to evaluate the degree of application of the person-centered gerontology care model in gerontology centers that collects the perception of residents who use these resources, their families and direct care professionals.

Method

After the selection and elaboration of items through interviews with people related to care for the elderly and their subsequent evaluation by a group of experts, a pilot study was carried out in which 32 items were selected. The analysis of the psychometric properties of the instrument was carried out with a sample of 265 people (81 direct care professionals, 99 residents and 85 family members) belonging to six gerontological centers in Gipuzkoa (Basque Country).

Results

The factorial structure of the questionnaire confirmed the existence of six highly correlated factors with adequate reliability coefficients. The convergent validity study confirmed significant correlations between the instrument and the Spanish version of the Staff Assessment Person Directed Care. On the other hand, significant correlations were found between the instrument, the burnout, the quality of work life in professionals and deterioration of cognitive functions, perception of quality of life and satisfaction with current life in the case of residents.

Conclusions

The questionnaire obtained has adequate psychometric properties, is an agile tool due to its brevity and is applicable for the three groups participating in the care, which overcomes limitations of other instruments adapted to our environment.

目的建立以人为本的老年医学护理模式在老年医学中心的应用程度评估工具，收集使用这些资源的居民、他们的家庭和直接护理专业人员的感受。方法通过对老年护理相关人员的访谈和专家评估，对项目进行筛选和细化后，选取32个项目进行初步研究。对来自Gipuzkoa（巴斯克地区）6个老年中心的265人（81名直接护理专业人员，99名居民和85名家庭成员）进行了心理测量特性分析。结果问卷的析因结构证实存在6个高相关因子，信度系数足够。收敛效度研究证实了该工具与西班牙语版工作人员评估个人指导护理之间的显著相关性。另一方面，专业人员的职业倦怠、工作生活质量与居民的认知功能恶化、生活质量感知和当前生活满意度之间存在显著相关。结论所获得的问卷具有足够的心理测量性质，是一种简洁的工具，适用于参加护理的三个群体，克服了其他适应我们环境的工具的局限性。

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引用次数: 0

Alternativa a la hospitalización convencional en los pacientes mayores con fragilidad 老年体弱多病患者替代传统住院治疗

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-31 DOI: 10.1016/j.regg.2025.101699

Matilde Barneto-Soto , María Eugenia Campollo Duquela , Emma Puigoriol-Juvanteny , Leidy Yohanna Ceballos Molina , Kathleen Gisselle Barahona Sandoval , Joan Espaulella-Panicot

Introduction

The growing population of elderly people with multimorbidity and frailty requires care models tailored to their specific needs. Subacute care units in intermediate care hospitals have emerged as an effective alternative to conventional hospitalisation in acute care settings. Appropriate patient selection is essential to enable the early identification of patients who may require prolonged care and to ensure efficient turnover. The objectives of this study were: i) to describe the characteristics of patients’ admitted and process indicators and; ii) to analyse potential factors associated with prolonged hospital stays (≥ 13 days).

Methods

Retrospective study was conducted including 208 patients admitted to a subacute care unit between January and December 2023. Demographic, clinical and functional variables were collected, as well as the reason for admission, prior healthcare resourcesuse, discharge destination, and readmission.

Results

The mean age was 82,5 ± 14,3 years, with a mean VIG-Frail score of 0.39 ± 0.13 and an average comorbidity of 6,8 ± 2,5. The median length of stay was 10,0 (P25:7; P75:13) days. A total of 67.3% of patients were discharged home, 85,7% of whom did so within 13 days. Patients identified as complex chronic cases prior to admission were more likely a mean length of stay ≥13 days (44,7 vs. 69,2%; P=.055).

Conclusions

Our unit is consolidated as an effective alternative to acute hospitalisation, enabling crisis management in elderly people with multimorbidity and frailty, and facilitating a time return home.

越来越多的患有多种疾病和身体虚弱的老年人需要根据他们的具体需求量身定制护理模式。中级护理医院的亚急性护理单元已成为急性护理环境中传统住院治疗的有效替代方案。适当的患者选择对于早期识别可能需要长期护理的患者并确保有效的转诊至关重要。本研究的目的是：i)描述患者入院和过程指标的特征；Ii)分析与延长住院时间（≥13天）相关的潜在因素。方法对2023年1月至12月在亚急性监护室住院的208例患者进行回顾性研究。收集了人口学、临床和功能变量，以及入院原因、既往医疗资源使用、出院目的地和再入院。结果患者平均年龄85.2±14.3岁，平均vig -虚弱评分为0.39±0.13，平均合并症为6.8±2.5。中位住院时间为10,0 (P25:7；P75:13)天。67.3%的患者出院，其中85.7%的患者在13天内出院。入院前确诊为复杂慢性病例的患者更有可能平均住院时间≥13天(44.7% vs. 69.2%；P = .055)。结论：sour单元可作为急性住院治疗的有效替代方案，使多重疾病和虚弱的老年人能够进行危机管理，并促进其及时回家。

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引用次数: 0

«¡Hemos envejecido mucho en estos dos años!». Efectos de la pandemia de COVID-19 sobre la salud de las personas mayores viviendo solas “这两年我们老了很多！”COVID-19大流行对独居老年人健康的影响

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-29 DOI: 10.1016/j.regg.2025.101687

María del Pilar Díaz Conde , Juan López Doblas

Background and objective

Surveys carried out around the world agree that the COVID-19 pandemic has deteriorated the health of older people. Those who live alone have been especially affected. Our objective is to analyze this fact, comprehensively interpreting the descriptions that they themselves transmit.

Method

Qualitative research that follows the guidelines of Grounded Theory and uses interviews to collect information. The theoretical sampling consisted of 102 interviews, all in person, carried out in several phases.

Results

Three main themes are identified. 1) The adoption of an inactive and sedentary lifestyle by older people living alone throughout the pandemic. 2) This was accompanied by a deficit in health care, since they avoided going to hospitals and health centers as they were conceived as spaces with a high risk of COVID-19 infection, that is, for fear of contagion. Telephone support was not an effective alternative to face-to-face consultations. 3) The loss of subjective health, which they attribute to the pandemic, in the form of physical worsening, especially related to mobility, mental problems such as anxiety or depression and/or perceived cognitive impairment.

Conclusions

The pandemic has negatively affected the health status of older people living alone, and its effects were not only immediate, but would last in the medium and long term. We are faced with a particularly vulnerable group and what has happened in recent years suggests the need for urgent and profound social interventions that improve their quality of life.

背景和目的在世界各地开展的调查一致认为，COVID-19大流行恶化了老年人的健康状况。独居者受到的影响尤其严重。我们的目标是分析这一事实，全面解释它们自己传递的描述。方法定性研究遵循扎根理论的指导方针，并使用访谈来收集信息。理论抽样包括102个访谈，所有访谈都是面对面的，分几个阶段进行。结果确定了三个主要主题。1)大流行期间独居老年人采取不活动和久坐不动的生活方式。2)这伴随着医疗保健的短缺，因为他们避免去医院和医疗中心，因为他们被认为是COVID-19感染风险很高的地方，也就是说，因为害怕传染。电话支助不是面对面协商的有效替代办法。3)主观健康的丧失，他们将其归因于大流行病，表现为身体状况恶化，特别是与行动能力、焦虑或抑郁等精神问题和/或认知障碍有关。结论新冠肺炎疫情对独居老年人的健康状况产生了负面影响，其影响不仅是立竿见影的，而且会持续中长期。我们面对的是一个特别脆弱的群体，近年来发生的情况表明，需要进行紧急和深刻的社会干预，以改善他们的生活质量。

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引用次数: 0

Efecto del envejecimiento sobre el contenido motor en la fluidez de verbos 老化对动词流畅性中的动词内容的影响

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-26 DOI: 10.1016/j.regg.2025.101700

L. Leonardo Díaz-García , Mireya Chávez-Oliveros , Julio C. Flores-Lázaro

Backround

Verb fluency is a sensitive neuropsychological test to frontostriatal integrity. Changes in brain physiology and morphology occur with aging, however, their impact on semantic aspects of the verb fluency is unknown.

Objective

To assess the effect of aging on the sequential production of motor content and lexical frequency in the verb fluency task.

Materials and Methods

Eighty-six subjects were recruited, organized into four age groups: 51-55, 56-60, 61-65 and 66-70 years. The production sequence was analyzed in four 15-second intervals of the verb fluency paradigm with three measures: verbs produced, motor content, and lexical frequency. Mood, global cognitive state, and education was controlled.

Results

An initial effect of high motor content is reported in a sample of older adults, consisting verb production with higher motor content during the first 15-seconds interval of verb fluency. This initial motor content is lower in the 66-70 age group compared to adults aged 51-60 years and is independent of the psycholinguistic and demographic variables analyzed.

Conclusions

This study is pioneering in providing data on motor content during verb fluency in an exploratory sample of older Mexican Spanish speakers; larger studies are needed to generalize the results. The importance of assessing semantic parameters in verb fluency as a promising tool for clinical practice in patients with frontostriatal impairment is highlighted.

背景动词流畅性是对额纹状体完整性的敏感神经心理学测试。随着年龄的增长，大脑的生理和形态会发生变化，然而，它们对动词流畅性的语义方面的影响尚不清楚。目的探讨年龄对动词流畅性任务中动作内容和词汇频率顺序产生的影响。材料与方法共招募受试者86例，分为51 ~ 55岁、56 ~ 60岁、61 ~ 65岁和66 ~ 70岁4组。在动词流畅性范式的四个15秒间隔内，用三个测量指标：动词产生量、动作内容和词汇频率来分析产生序列。情绪、整体认知状态和教育受控制。结果高运动内容的初始效应在老年人样本中被报道，包括在动词流利的前15秒间隔内产生较高的运动内容的动词。与51-60岁的成年人相比，66-70岁年龄组的初始运动内容较低，并且与所分析的心理语言学和人口统计学变量无关。本研究开创性地提供了对老年墨西哥西班牙语使用者在动词流利性过程中运动内容的数据；需要更大规模的研究来推广结果。评估动词流畅性的语义参数的重要性，作为一个有前途的工具，在临床实践的患者额纹状体损伤被强调。

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引用次数: 0

Functional recovery unit national map. FUN-RUN Map Project 功能恢复单位全国地图。FUN-RUN地图项目

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-24 DOI: 10.1016/j.regg.2025.101701

Ainhoa Esteve Arrien , Elena Romero Pisonero , Elena Fernández Arin , Alicia Calle Egusquiza , José Manuel Cancio Trujillo

Introduction

Functional recovery units (FRUs) provide bed-based functional reablement for adults affected by morbidity-related or healthcare system-induced functional decline. Despite strong evidence supporting their efficacy, FRU development has been uneven within national territory. This project aims to identify territorial accessibility to FRUs in Spain in 2024. The project's objectives included describing structure–process–outcome indicators and collecting staff opinions on some of these metrics.

Methods

A cross-sectional study was designed using a piloted questionnaire in an encrypted online platform, comprising sociodemographics, center-characteristics, unit-characteristics, and staff opinions. Inclusion criteria included publicly funded hospital units focused on geriatric rehabilitation, managed by physicians with MIR specialty. One hundred IC-Hospitals (ICH) were identified as potentially eligible within the National Catalogue of Hospitals, 55 centers meeting inclusion criteria where clinical referees were identified.

Results

Thirty-two questionnaires completed (response rate 58%) by geriatricians (81.25%), with an average of 13.4 years of FRU-experience. Geographic representation included 11 provinces and eight autonomous communities. 87.5% of FRUs are located in ICH and have an average experience of 22.69 years. 0.52 beds per 1000 inhabitants >65 years and 1.7 beds per 1000 >80 years were described in the provinces represented, and a national ratio of 0.2 beds/1000 >65 years and 0.7 beds/1000 >80 years. Staff ratios of 15.94 and 14.91 beds/doctor and beds/nurse slightly differ from the opinion of referees ideal of 14.3 beds/doctor and 11.7 beds/nurse. Structure, process and outcomes indicators are exhaustively described.

Conclusions

A national consensus is needed, integrating general recommendations/processes, Quality-standards stratification to optimize effectiveness and efficiency of these units and patients’ opinions to improve care quality and standards.

功能恢复单元（fru）为受发病率相关或卫生保健系统引起的功能下降影响的成年人提供基于床的功能恢复。尽管有强有力的证据支持其有效性，但FRU在国家范围内的发展并不均衡。该项目旨在确定2024年西班牙fru的领土可达性。该项目的目标包括描述结构-过程-结果指标，并收集工作人员对其中一些指标的意见。方法采用加密在线平台上的试点问卷设计横断面研究，包括社会人口统计学、中心特征、单位特征和员工意见。纳入标准包括由MIR专业医生管理的以老年康复为重点的公共资助医院单位。100家ic医院（ICH）被确定为符合国家医院目录的潜在资格，55家中心符合纳入标准，其中确定了临床裁判。结果老年医师（81.25%）共完成问卷32份，回复率58%，平均从事fru工作13.4年。地域代表性包括11个省和8个自治区。87.5%的fru位于非ICH，平均经验为22.69年。在所代表的省份，每1000名65岁的居民有0.52张床位，每1000名80岁的居民有1.7张床位，全国比例为0.2张床位/1000名65岁和0.7张床位/1000名80岁。员工比率分别为15.94张/医生及14.91张/护士，与裁判员理想的14.3张/医生及11.7张/护士有轻微差异。详尽地描述了结构、过程和结果指标。结论需要形成全国共识，整合一般建议/流程、质量标准分层优化单位效能和效率、患者意见提高护理质量和水平。

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引用次数: 0

Acidosis láctica por metformina, hipofosfatemia severa e hipocalcemia severa: un desafío diagnóstico y terapéutico 二甲双胍乳酸中毒、严重低磷酸血症和严重低钙血症：诊断和治疗方面的挑战

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-14 DOI: 10.1016/j.regg.2025.101698

Cristina Aragón Hernández , Leire Eguzkiza-Ezponda , Ivon Y. Rivera Deras , Francisco José Sanz Segovia

引用次数: 0

Programa de formación de cuidadores familiares de personas mayores en Chile: un estudio cualitativo 智利老年照料者培训方案：定性研究

Q3 Medicine

Revista Espanola de Geriatria y Gerontologia

Pub Date : 2025-07-14 DOI: 10.1016/j.regg.2025.101689

Cecilia Zavala Guzmán, Paula Jaman-Mewes, Carolina Arias Vivanco, María del Pilar Ureta Fernández

Background and objective

Population aging in Latin America, particularly in Chile, is advancing rapidly, increasing the demand for trained caregivers who can provide quality care. However, caregiver training remains limited, and online education programs represent an innovative alternative. This study aimed to describe the experiences of family caregivers of older adults who participated in an online training program developed by a Chilean university.

Methods

A descriptive qualitative study with content analysis was conducted. Purposive sampling was used, and semi-structured interviews were carried out with 11 female family caregivers who participated in a 13-session online training program. The content was based on comprehensive geriatric assessment (physical, mental, functional, social, and spiritual domains) and caregiver self-care.

Results

Family caregivers valued the program as a space that provided both knowledge and emotional support to help them face their caregiving responsibilities. Four main categories emerged from the analysis: 1) multiple learnings; 2) simulation led by nursing students; 3) meaningful support, and 4) awareness of the caregiving role and the need for ongoing learning.

Conclusions

The online educational program was well received by caregivers, who reported relevant learning experiences and greater awareness of their role. Although findings should be interpreted with caution due to the small sample size, the program may help strengthen caregiver competencies and support networks. Adapting content to diverse contexts and assessing program sustainability is recommended.

背景和目的拉丁美洲，特别是智利的人口老龄化正在迅速推进，这增加了对能够提供高质量护理的训练有素的护理人员的需求。然而，护理人员培训仍然有限，在线教育项目代表了一种创新的选择。本研究旨在描述参加智利一所大学开发的在线培训计划的老年人家庭照顾者的经历。方法采用内容分析的描述性定性研究方法。采用有目的的抽样方法，对参加了13期在线培训计划的11名女性家庭照顾者进行了半结构化访谈。内容是基于全面的老年评估（身体，心理，功能，社会和精神领域）和照顾者的自我照顾。结果家庭照顾者认为该项目提供了知识和情感支持，帮助他们面对照顾责任。从分析中可以得出四个主要类别：1)多重学习；2)由护生主导模拟；3)有意义的支持；4)意识到照顾者的角色和持续学习的需要。结论在线教育项目受到护理人员的欢迎，他们报告了相关的学习经验，并提高了他们的角色意识。虽然由于样本量小，研究结果应谨慎解释，但该计划可能有助于加强护理人员的能力和支持网络。建议根据不同的背景调整内容并评估项目的可持续性。

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引用次数: 0