Revista Espanola de Geriatria y Gerontologia最新文献

The aim of this review was to know the existing scientific production on therapeutic exercise in older adults. A bibliographic search was carried out on 2023 January in Pubmed, Scopus, Web of Science and Sportdiscus databases. Selection criteria were: people aged 65 and above, healthy or with any pathology, and therapeutic exercise programs exclusive or associated with other complications. Language, publication date, and study design were not limited. Data extracted were: year, study type, design and methodology, country of the study and specialty of the journal where it was published.

1094 studies were obtained from 1967 to 2021. The scientific production had a slow evolution until the 2010s when the number of articles began to be significant. According to the types of study, 6.9% were systematic review, 90% research studies, 0.5% opinion studies, and 2.6% other types of studies. The most abundant specialties are geriatrics and gerontology (38.8%), and rehabilitation (16.1%), concentrating more than 50% of the total production. According to the study countries, only 4 concentrated 50% of the publications: the United States (29.16%), Australia (7.95%), Canada (7.31%) and the United Kingdom (6.95%).

Background

Mild Cognitive Impairment (MCI) is considered a decline in cognitive functions, which becomes more pronounced with age. These patients may benefit from cognitive treatments that help attenuate or slow down a potential progression towards dementia.

Objective

To assess the feasibility, fidelity, satisfaction, and effectiveness of the Memory Training and Cognitive Stimulation Program (PEMEC, by its Spanish acronym) in individuals with MCI in an online setting.

Method

A non-probabilistic convenience sample of 14 patients with MCI received the PEMEC (PEMEC online) through an electronic device, were assessed with MoCA, NEUROPSI Brief, Yesavage Geriatric Depression Scale before and after treatment, comparing these measurements with those of a waiting list control group.

Results

92,85% completed the treatment; with an average of 92% fidelity to the original intervention, an average of 91,61% for satisfaction with the activities of each session and the perceived usefulness was 97,98%. Statistically significant differences were found in the NEUROPSI Brief and the MoCA, before and after treatment in the intervention group and, when comparing the scores with the waiting list control group, a statistically significant difference was found in the MoCA scores.

Conclusion

Following the cultural adaptation of the program (from a Spanish to a Mexican treatment group), these results establish a precedent that systematic group cognitive interventions are feasible and effective in virtual tele-neuropsychology contexts for older adults.

Objetive

To determine the influence of different factors involved in the decision to apply physical restraints (PR) in the management the elderly people with conduct disorders in an emergency department (ED)

Methods

A prospective observational study was conducted in the ED of the Hospital Universitario Severo Ochoa (Leganés, Madrid). We included 125 elderly people with disruptive behaviors and collected clinical, patient handling, organizational and environmental variables. Individuals who had undergone PR were analyzed to learn what factors were related to the final decision to restrain.

Results

32.8% of the participants underwent PR. The aspects that most influenced the decision to restrain were those related to the organization and environment: specific staff training decreased the probability of restraint by 50% (P<.05) and good support from the whole team reduced the risk of using SF by up to 75% (P<.0005).

Related patient handling factors such as verbal restraint, pain relief, family accompaniment and early mobilization significantly reduced the use of PR (P<.05). The only patient-dependent clinical aspect that increased the risk of SF was male sex (P<.05).

Other factors unrelated to the probability of applying PR were, among others, nurse-patient ratio, type of behavior, age, or functional/cognitive status.

Conclusions

Exclusively clinical factors of the patient had little influence on the decision to restrain the elderly in an ED. However, environmental, organizational, and behavioral handling variables could favor more respectful alternatives and thus reduce the use of PR in the elderly with disruptive behaviors in the ED.

Introduction

During the aging process, different changes in the body structures appear, increasing the susceptibility to develop type 2 diabetes (T2DM) and mild cognitive impairment (MCI). The association between T2DM and MCI has been described in different studies. Despite the scientific evidence that shows that cognitive rehabilitation improves the cognitive performance of older adults with MCI, currently, there are few studies evaluating the effectiveness of cognitive rehabilitation in older adults with T2DM and MCI.

Participants and methods

Pretest and posttest quasi-experimental design. Participants will be randomly assigned (1:1) to the intervention and control groups. The intervention group will undergo a 12-week cognitive rehabilitation program with a restorative approach. The control group will not receive any intervention. All participants will be followed up three months after randomization.

Expected results

To develop a cognitive rehabilitation program that improves memory, processing speed and executive functions, as well as the level of glycemic control of the participants assigned to the intervention group. These results will allow us to acquire the necessary data to carry out a pilot test.

Conclusions

This is the first quasi-experimental study in Mexico in which a cognitive rehabilitation program with a restorative approach is developed for older adults with T2DM and MCI. By carrying out this program, older adults will have an alternative treatment that improves their autonomy, specifically in the control of T2DM. In addition, this study makes important methodological contributions in the lines of research of T2DM and MCI.

In this article, we review the main theories of biological aging, exploring the interaction of genetic, epigenetic, metabolic, immunological, and ecological factors in this process. For this purpose, we examine and discuss theories such as the allocation of metabolic resources, pleiotropic antagonism, genetic regulation, codon restriction, replicative senescence, action of free radicals, caloric restriction, catastrophic error, immunological theory, neuroendocrine theory, programmed aging, epigenetics of aging, grandmother and caregiver theories and ecological biophysical theory. We identify the contribution of different biological mechanisms to aging, emphasizing the complementarity of theories such as the allocation of metabolic resources, pleiotropic antagonism, and caloric restriction, providing a more comprehensive view of the phenomenon. In conclusion, we highlight the need to consider diverse perspectives in aging research, recognizing the absence of a single explanation. Integrating these theories is crucial to comprehensively understand the process and develop effective interventions in health and well-being in old age.

Background and objectives

The objective is to describe the demographic, clinical, functional characteristics and outcomes of older adult patients hospitalized in the acute unit of the San Ignacio University Hospital (HUSI).

Methods

Descriptive, cross-sectional observational study, based on the review of the medical records of patients hospitalized in the Geriatrics Unit of the HUSI during the period 2019-2021. Variables: Demographics, comorbidities, baseline situation, main cause of entry and outcomes. The diagnosis of geriatric syndromes was made through the Barthel index, the Lawton and Brody scale, FRAIL scale, mini nutritional assessment short form and Confusion Assessment Method criteria.

Results

A total of 4601 patients were analyzed, whose average age was 83 years (56.2% women). 72.4% had some degree of dependency for basic activities of daily living, 90.8% had some degree of dependency for instrumental activities of daily living, 32.2% had malnutrition, 15. 7% falls, 9.9% oropharyngeal dysphagia, 32.2% frailty, 28.1% delirium, 54.1% previous dementia. The main comorbidities presented were arterial hypertension, chronic obstructive pulmonary disease and diabetes. 2.9% had some complication during their hospitalization, 10.8% died, and the hospital stay was 5 days.

Conclusion

Older adult patients admitted to the acute unit of the HUSI have a high frequency of dependency, dementia and nutritional disturbances.