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PReCAMDi Programa de Rehabilitación Cognitiva para Adultos Mayores con Diabetes tipo 2: protocolo de estudio cuasiexperimental [针对 2 型糖尿病老年人的 PReCAMDi 认知康复计划:准实验研究方案]。
Q3 Medicine Pub Date : 2024-07-24 DOI: 10.1016/j.regg.2024.101534
Yessica Ventura-Santander

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.

导言在衰老过程中,身体结构会发生不同的变化,从而增加患上 2 型糖尿病(T2DM)和轻度认知障碍(MCI)的几率。不同的研究都描述了 T2DM 和 MCI 之间的关联。尽管有科学证据表明,认知康复可改善患有 MCI 的老年人的认知能力,但目前很少有研究评估认知康复对患有 T2DM 和 MCI 的老年人的有效性:前测和后测准实验设计。参与者将被随机分配(1:1)到干预组和对照组。干预组将接受为期 12 周的恢复性认知康复计划。对照组不接受任何干预。所有参与者将在随机分组三个月后接受随访:制定一项认知康复计划,改善干预组参与者的记忆力、处理速度和执行功能,以及血糖控制水平。这些结果将使我们获得开展试点测试所需的数据:这是墨西哥第一项针对患有 T2DM 和 MCI 的老年人制定的恢复性认知康复计划的准实验研究。通过实施该计划,老年人将获得另一种治疗方法,提高他们的自主能力,特别是在控制 T2DM 方面。此外,这项研究还在 T2DM 和 MCI 的研究方法上做出了重要贡献。
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引用次数: 0
Planificación anticipada de cuidados en residencias de mayores: a propósito de un caso [养老院的预先护理计划:关于一个案例]。
Q3 Medicine Pub Date : 2024-07-24 DOI: 10.1016/j.regg.2024.101528
Cristina Jiménez-Domínguez , Jesus Mateos-Nozal , Carmen Figueroa-Lin Kí , Lourdes Rexach-Cano
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引用次数: 0
Teorías del envejecimiento biológico: una revisión integradora 生物老化理论:综合评述
Q3 Medicine Pub Date : 2024-07-11 DOI: 10.1016/j.regg.2024.101530
Fabián Aníbal Quintero , Mariela Garraza , Bárbara Navazo , María Florencia Cesani

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.

本文回顾了生物衰老的主要理论,探讨了这一过程中遗传、表观遗传、代谢、免疫和生态因素的相互作用。为此,我们研究并讨论了代谢资源分配、多效拮抗、遗传调控、密码子限制、复制衰老、自由基作用、热量限制、灾难性错误、免疫学理论、神经内分泌理论、程序性衰老、衰老的表观遗传学、祖母和照顾者理论以及生态生物物理学理论等理论。我们确定了不同生物机制对衰老的贡献,强调了新陈代谢资源分配、多生物拮抗作用和热量限制等理论的互补性,从而对衰老现象有了更全面的认识。总之,我们强调在衰老研究中需要考虑不同的视角,认识到缺乏单一的解释。整合这些理论对于全面了解老龄化过程和制定有效的干预措施至关重要。
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引用次数: 0
Caracterización de los pacientes adultos mayores ingresados a una unidad de agudos de un hospital de alta complejidad en Bogotá, Colombia [哥伦比亚波哥大一家综合医院急诊科收治的老年病人的特征]。
Q3 Medicine Pub Date : 2024-07-03 DOI: 10.1016/j.regg.2024.101527
Diego Andrés Chavarro-Carvajal , Eduardo José Pabón-Martínez , Ana Karina Negrette Soto , Jose Manuel Santacruz Escudero , Carlos Alberto Cano-Gutierrez

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.

背景和目的:目的是描述在圣伊格纳西奥大学医院急诊科住院的老年患者的人口、临床、功能特征和治疗效果:目的:描述在圣伊格纳西奥大学医院(HUSI)急诊科住院的老年患者的人口统计学、临床、功能特征和预后:描述性横断面观察研究,基于对2019-2021年期间在圣伊格纳西奥大学医院老年病科住院患者病历的审查:人口统计学、合并症、基线情况、主要入院原因和结果。通过巴特尔指数、劳顿和布罗迪量表、FRAIL量表、迷你营养评估简表和混乱评估法标准对老年综合征进行诊断:共分析了 4601 名患者,他们的平均年龄为 83 岁(女性占 56.2%)。72.4%的患者在日常生活基本活动方面有一定程度的依赖性,90.8%的患者在日常生活工具性活动方面有一定程度的依赖性,32.2%的患者营养不良,15.7% 跌倒,9.9% 口咽吞咽困难,32.2% 身体虚弱,28.1% 精神错乱,54.1% 曾患痴呆症。主要合并症为动脉高血压、慢性阻塞性肺病和糖尿病。2.9%的患者在住院期间出现并发症,10.8%的患者死亡,住院时间为5天:结论:入住重症监护病房急诊科的老年患者依赖性强、痴呆和营养障碍的发生率很高。
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引用次数: 0
Lanzando la moneda. Desarrollo de una prueba informática para evaluar la flexibilidad cognitiva en las personas mayores [掷硬币:开发评估老年人认知灵活性的计算机化测试]。
Q3 Medicine Pub Date : 2024-07-03 DOI: 10.1016/j.regg.2024.101514
Matías Jonás García , Isabel María Introzzi , Yesica Sabina Aydmune , Ana Comesaña

Background

The aging population is increasing. Aging has been associated with some degree of cognitive decline, especially in functions such as cognitive flexibility. The voluntary task-switching paradigm is a novel model for studying this function. The aim of this work was to design and test a computerized instrument to assess cognitive flexibility with this paradigm.

Methods

A non-probabilistic and intentional sample of individuals aged 60 and above (N = 57; M = 70; SD = 7.5), 72% of whom were women, was utilized. A general cognitive screening test (ACE III) and the “Coin Tossing” task, a computerized program consisting of four levels of complexity, were administered.

Results

A Wilcoxon test was used to contrast parity versus size responses (z(56) = −1.16, P=.24). To assess repetition bias, a Wilcoxon test was conducted between new and repeated responses (TR: z(56) = −1.81, P=.07 // Accuracy: z(56) = −6.33, P=.00). A repeated measures ANOVA was performed between reaction times before, during, and after a response change, F(1.02) = 59.6, P<.01, η2 = .937, B-1 = 1. And a repeated measures ANOVA between mean RTs per level, F(3) = 7.92, P<.001, η2 = .128, B-1 = .98.

Conclusions

The test was designed with a progressive structure across levels. The theoretical assumptions of the paradigm were partially demonstrated, showing its utility for the assessment and training of cognitive flexibility.

背景:老龄化人口在不断增加。衰老与一定程度的认知能力下降有关,尤其是在认知灵活性等功能方面。自愿任务转换范式是研究这种功能的一种新模式。这项工作的目的是设计和测试一种计算机化工具,用这种范式评估认知灵活性:方法:研究人员对 60 岁及以上的个体(N=57;M=70;SD=7.5)进行了非概率性的有意抽样调查,其中 72% 为女性。对他们进行了一般认知筛选测试(ACE III)和 "掷硬币 "任务(一个由四个复杂程度组成的电脑程序):Wilcoxon 检验用于对比奇偶性与大小反应(z(56)=-1.16,P=.24)。为了评估重复偏差,对新回答和重复回答进行了 Wilcoxon 检验(TR:z(56)=-1.81,P=.07 // 准确性:z(56)=-6.33,P=.00)。在反应改变之前、之中和之后的反应时间之间进行了重复测量方差分析,F(1.02)=59.6,PC 结论:该测试设计了一个跨水平的渐进结构。该范式的理论假设得到了部分验证,显示了其在评估和训练认知灵活性方面的实用性。
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引用次数: 0
Diversidad dietética, estado antropométrico y perfil bioquímico de centenarios de la Península de Nicoya, Costa Rica, y su descendencia [哥斯达黎加尼科亚半岛百岁老人及其后代的膳食多样性、人体测量状况和生化特征]。
Q3 Medicine Pub Date : 2024-07-03 DOI: 10.1016/j.regg.2024.101513
Georgina Gómez Salas , Raquel Arriola Aguirre , Laura Vindas Meza , Adrián Pinto Tomás , Juan José Cordero Solís , Isabel Barrientos Calvo , Ana M. Pérez Carvajal

Background and objective

Social relationships, physical activity and diet have been proposed as responsible for longevity; however, many of these conditions have changed in modern societies. The objective of this study was to identify if the anthropometric status, biochemical profile and diet of Nicoyan centenarians is different from that of their decency and if the quality and diversity of the diet of these Costa Ricans differs from that of adults from urban areas of the same country.

Materials and methods

Anthropometric, biochemical and dietary assessments were carried out on 120 adults residing in the Nicoya Peninsula, including centenarians, their children and grandchildren. The data were analyzed using descriptive and inferential statistics.

Results

There is a significantly lower percentage of excess weight, central adiposity and blood lipids in Nicoyan centenarians compared to their children and grandchildren. The consumption of «Dairy» and «Other fruits» is higher in centenarians than in their descendants. Centenarians showed a higher dietary diversity index (DDI) compared to other age categories, and they also showed a higher DDI and a significantly more diverse diet than the urban population of Costa Rica.

Conclusion

Nicoyan centenarians presented a better lipid and glycemic profile than their offspring, they have lower weight and a better quality and diversity of diet than their relatives and than adults from the urban area of Costa Rica.

背景和目的:社会关系、体育活动和饮食被认为是长寿的原因;然而,在现代社会中,这些条件中的许多都发生了变化。本研究旨在确定尼科西亚百岁老人的人体测量状况、生化特征和饮食是否与同龄人不同,以及这些哥斯达黎加人的饮食质量和多样性是否与该国城市地区的成年人不同:对居住在尼科亚半岛的 120 名成年人(包括百岁老人及其子孙)进行了人体测量、生物化学和饮食评估。采用描述性和推论性统计方法对数据进行了分析:结果:与子女和孙辈相比,尼科亚百岁老人的超重比例、中心脂肪含量和血脂含量明显较低。百岁老人的 "乳制品 "和 "其他水果 "消费量高于其子孙。与其他年龄组相比,百岁老人的膳食多样性指数(DDI)较高,与哥斯达黎加城市人口相比,百岁老人的膳食多样性指数也较高,膳食多样性程度明显更高:尼科西亚百岁老人的血脂和血糖状况优于其后代,体重低于其亲属,饮食质量和多样性优于哥斯达黎加城市地区的成年人。
{"title":"Diversidad dietética, estado antropométrico y perfil bioquímico de centenarios de la Península de Nicoya, Costa Rica, y su descendencia","authors":"Georgina Gómez Salas ,&nbsp;Raquel Arriola Aguirre ,&nbsp;Laura Vindas Meza ,&nbsp;Adrián Pinto Tomás ,&nbsp;Juan José Cordero Solís ,&nbsp;Isabel Barrientos Calvo ,&nbsp;Ana M. Pérez Carvajal","doi":"10.1016/j.regg.2024.101513","DOIUrl":"10.1016/j.regg.2024.101513","url":null,"abstract":"<div><h3>Background and objective</h3><p>Social relationships, physical activity and diet have been proposed as responsible for longevity; however, many of these conditions have changed in modern societies. The objective of this study was to identify if the anthropometric status, biochemical profile and diet of Nicoyan centenarians is different from that of their decency and if the quality and diversity of the diet of these Costa Ricans differs from that of adults from urban areas of the same country.</p></div><div><h3>Materials and methods</h3><p>Anthropometric, biochemical and dietary assessments were carried out on 120 adults residing in the Nicoya Peninsula, including centenarians, their children and grandchildren. The data were analyzed using descriptive and inferential statistics.</p></div><div><h3>Results</h3><p>There is a significantly lower percentage of excess weight, central adiposity and blood lipids in Nicoyan centenarians compared to their children and grandchildren. The consumption of «Dairy» and «Other fruits» is higher in centenarians than in their descendants. Centenarians showed a higher dietary diversity index (DDI) compared to other age categories, and they also showed a higher DDI and a significantly more diverse diet than the urban population of Costa Rica.</p></div><div><h3>Conclusion</h3><p>Nicoyan centenarians presented a better lipid and glycemic profile than their offspring, they have lower weight and a better quality and diversity of diet than their relatives and than adults from the urban area of Costa Rica.</p></div>","PeriodicalId":39958,"journal":{"name":"Revista Espanola de Geriatria y Gerontologia","volume":"59 6","pages":"Article 101513"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535606","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
Impact of a geriatric intervention based on the Comprehensive Geriatrics Assessment on avoidable admissions in older patients at risk evaluated in the Emergency Department 基于老年医学综合评估的老年医学干预措施对急诊科评估的高危老年患者可避免的入院治疗的影响
Q3 Medicine Pub Date : 2024-06-08 DOI: 10.1016/j.regg.2024.101512
Paula Fernández-Montalbán , Sara Martínez-Flores , María Mir-Montero , José Ramón Arribas López , Carlos Bibiano-Guillén , Fátima Brañas

Objective

To know the impact of a geriatric intervention based on the Comprehensive Geriatric Assessment (CGA) on avoidable admissions in older patients at risk evaluated in the Emergency Department.

Method

Prospective observational unicenter study. We included patients, from October 1, 2018 to January 31, 2020, over 75 years who were attended at the Emergency Department with a Triage Risk Screening Tool (TRST) score  2. All patients were evaluated by a geriatrician through the CGA. The reasons for going to the Emergency room were collected and also the main intervention carried out by Geriatrics, whether admission or discharge was indicated and whether the admission was avoidable. We did a cost analysis calculating this by (bed/day × average stay × number of admissions avoided).

Results

We included 260 patients, 66% were women and the mean age was 86 years. 73.5% patients had polypharmacy, the mean Charlson index was 2.5 (5.6). 63.3% were independent for walking and 20.8% independent for basic activities of daily living. 59% had cognitive impairment. 91.5% lived at home. The most frequent reason for visiting the Emergency room was decline of general state in 22% and the most frequent intervention carried out by Geriatrics was assistance in the decision making process in 35.4% followed by referral to a preferential outpatient geriatric care circuit in 32.7%. Other interventions carried out by Geriatrics was assistance in clarifying diagnosis (4.2%), assistance in pharmacological adjustment (8.5%), referral to a standard geriatric care pathway (13.1%), telephone follow-up (4.2%) and/or coordination with Social Services for care planning (11.2%).

Including all patients, 29.2% required hospital admission and 70.8% were discharged. 40% admissions were avoided, which meant more than 540 thousand euros saved.

Conclusions

A standardized CGA coordinated by Geriatrics in older patients at risk of suffering adverse events in the Emergency room reduces admissions and costs, so it should therefore be established as a recommendation of good clinical practice.

目的 了解基于老年医学综合评估(CGA)的老年医学干预措施对急诊科评估的高危老年患者可避免的入院治疗的影响。我们纳入了2018年10月1日至2020年1月31日期间在急诊科就诊且分诊风险筛查工具(TRST)评分≥2分的75岁以上患者。所有患者均由一名老年病学专家通过 CGA 进行评估。我们收集了患者前往急诊室的原因、老年病科采取的主要干预措施、是否需要入院或出院以及是否可以避免入院。我们进行了成本分析,计算方法是(床位/天×平均住院天数×避免入院次数)。73.5%的患者使用多种药物,平均 Charlson 指数为 2.5(5.6)。63.3%的患者能独立行走,20.8%的患者能独立进行基本的日常生活活动。59%的患者有认知障碍。91.5%的患者住在家中。到急诊室就诊最常见的原因是一般状态下降,占 22%,老年医学科最常见的干预措施是协助 35.4% 的患者做出决定,其次是将 32.7% 的患者转介到优先老年医学门诊护理中心。老年医学科采取的其他干预措施包括协助明确诊断(4.2%)、协助调整药物(8.5%)、转诊至标准老年医学护理路径(13.1%)、电话随访(4.2%)和/或与社会服务部门协调制定护理计划(11.2%)。结论 对急诊室有不良事件风险的老年患者,由老年医学部门协调的标准化 CGA 可减少入院次数和费用,因此应将其确立为良好临床实践的一项建议。
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引用次数: 0
In memoriam del Dr. Juan José Solano Jaurrieta [纪念胡安-何塞-索拉诺-若列塔博士]。
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.regg.2024.101510
Leocadio Rodríguez Mañas , Carlos Alberto Cano Gutiérrez
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引用次数: 0
Lesiones vesiculosas sobre base eritematosa en el anciano: no todo es herpes zóster [老年人红斑基础上的水泡性病变:并非一切都是带状疱疹]。
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.regg.2024.101509
Miguel Mansilla-Polo , Begoña Escutia-Muñoz , Daniel Martín-Torregrosa , Rafael Botella-Estrada
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引用次数: 0
La obligación ética de seguir investigando durante la jubilación [退休后继续研究的道德义务]。
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.regg.2024.101511
Manuel Ortega-Calvo

We advocate in this little assay for the concept of active retirement. We feel the need to broadcast our experience to younger professionals. Mentor, Telemachus’ advisor in the Odyssey, has evolved greatly into the 21st century. From an ideal point of view, we consider that clinical practice is inextricably linked to research. Within the public health system there is an ethical space for volunteering. Perhaps it is what Anglo-Saxon primary care calls “vocational training”.

我们在这篇小论文中倡导积极退休的概念。我们认为有必要向年轻的专业人士介绍我们的经验。导师,《奥德赛》中忒勒马科斯的顾问,在 21 世纪已经有了很大的发展。从理想的角度来看,我们认为临床实践与研究密不可分。在公共卫生系统中,有一个志愿服务的道德空间。也许这就是盎格鲁-撒克逊初级保健所说的 "职业培训"。
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引用次数: 0
期刊
Revista Espanola de Geriatria y Gerontologia
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