Efectos del ejercicio físico sobre la calidad del sueño,insomnio y somnolencia diurna en personas mayores. Revisión de la literatura

The ageing process alters the stages of sleep, and the elderly that have this problem tend to be prescribed pharmacological treatment. This has long term side effects and results in increased health costs. On the other hand, frequent or regular physical exercise could be an overall superior alternative, due to its multifactorial effects. It is also less expensive, thus more affordable and accessible. Furthermore, these benefits could be extrapolated to the quality of sleep. Taking this into account the purpose of this paper is to establish the proper amount of physical exercise using the FITT (frequency, intensity, time, type of exercise) principle, and its effect on the quality of sleep, insomnia, and daytime sleepiness in the elderly. This could lead us to a paradigm shift in the treatment of sleep disorders, and also may constitute an alternative method for treating the elderly.     

Comparación de los libros de historia de vida digitales y convencionales sobre el estado de ánimo,la comunicación,la cognición y la calidad de vida en personas con demencia en residencias: un estudio piloto

IntroductionPerson-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life.Material and methodsThirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n = 16) or a conventional LSB (n = 15). Both groups performed 2 weekly sessions of 45 min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program.ResultsBoth LSB improved communication skills (η² = 0.115; p < 0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found.ConclusionsIn PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain.     

Impacto en residencias de la atención centrada en las personas (ACP) sobre la calidad de vida,el bienestar y la capacidad de salir adelante. Estudio transversal

IntroductionThe aging of the population has led to the introduction of qualitative and quantitative changes in healthcare resources, among which are the introduction of models of person-centred care (PCC), although there is a lack of information on their impact. The objective of this study is to assess the impact of a PCC model on the quality of life, well-being and thriving, in people living in nursing homesMethodsCross-sectional study. Population: all persons who lived indefinitely in the two participating centres that gave their consent. Impact of PCC vs. traditional model was assessed in terms of quality of life, well-being and thriving. Effect size was estimated with Cohen d adjusted for health problems, Charlson index, and presence of depression.ResultsOverall participation was 78% (59/77 persons from the conventional centre and 66/88 from the PCC). The people of the PCC centre had better well-being (d = 0.378) and thriving (d = 0.566). No differences were found in quality of life.ConclusionThe PCC model can have a positive impact on well-being and thriving in persons living in nursing homes.     

Programas para combatir la soledad en las personas mayores en el ámbito institucionalizado: una revisión de la literatura científica

Loneliness is a problem that affects a very high percentage of older people, and can lead to physical and/or mental illness. This article aims to present a systematic review of programs to combat loneliness directed towards the institutionalised elderly. Experimental and quasi-experimental articles published between 2000 and 2016 were included in the review. An analysis was carried out on the quality of the methodological evidence of each of the articles. The programs analysed included animal-assisted, contacts with families through videoconferencing, gardening and/or horticulture workshops, reminiscence therapies, humour therapies, and cognitive interventions. The results show that intervention programs are effective to reduce the feeling of loneliness. The methodological limitations of the studies are discussed and future research is recommended.     

La salud de las personas mayores en España durante la crisis económica

Introduction

Numerous studies have shown that economic crises are linked to a worsening of health conditions of the population. During the current economic crisis in Spain, there have been significant cuts in social and health services and a general worsening of the emotional well-being of the population. All these changes could have an impact on the health of the population, especially in the most vulnerable groups like older people.

Diseño y validación de dos escalas sobre actitudes y conocimientos ante la terapia con muñecas en demencias

IntroductionNon-pharmacological interventions are often the subject of debate in the scientific field. Therefore, it is essential to know the attitudes that health professionals have towards the novel Doll Therapy in Dementia (DTD). The objective of this study was to design and validate two questionnaires to find out the attitudes and knowledge on DTD in health professionals.Material and methodsA total of 120 Spanish-speaking Geriatrics and Gerontology professionals, with a mean age of 38.3 years (DT = 10.99), participated, mostly women (88.3%). A questionnaire (TCM_DEMCO) on knowledge about the DTD and a questionnaire (TCM_DEMAC) on attitudes towards the DTD were designed and applied. The construct validity was assessed by exploratory factor analysis, and reliability was calculated using Cronbach's α.ResultsThe exploratory factor analysis of the TCM_DEMCO questionnaire retained 10 items in 5 factors (“environment and dementia”, “therapeutic application”, “activities”, “methodology” and “benefits and implications”) that explained 70.1% of the total variability, giving a Cronbach α coefficient value > 0.50. The exploratory factor analysis of the TCM_DEMAC questionnaire retained 10 items in two factors (“positive attitudes” and “negative attitudes”) that explained 61.2% of the total variability, giving a Cronbach α value > 0.85.ConclusionsBoth questionnaires are a brief tool to learn about the attitudes and knowledge of Spanish-speaking Geriatrics and Gerontology professionals in matters of DTD. The reliability and validity analyses performed showed good psychometric properties of these tools.     

Utilidad clínica de la micafungina en el niño y el adolescente

Micafungin is one of three echinocandins, a novel class of antifungal agents active against 1,3-β-D glucan in the fungal cell wall. It is a favorable safety profile have made it an attractive option in the treatment of invasive Candida and Aspergillus infections. Available studies have shown that younger children have lower C_max, shorter t½ and faster clearance than adults.     

Tendencias en las hospitalizaciones psiquiátricas de personas mayores de 65 años

BackgroundThe aim of this study was to analyse the trend in the percentages of elderly patients admitted to hospital for psychiatric reasons. An additional aim was to analyse the characteristics of the elderly population admitted to a psychiatric hospitalisation unit.Material an MethodsAn analysis was made of the trends in the percentages of discharges in elderly population at the national level and in the Mental Health Hospitalisation Unit (MHHU) of the Regional University Hospital of Malaga for a period of at least 18 years using segmented regression. For the study of the characteristics of the elderly population, all patients (N = 5,925) and consecutive episodes of admission (N = 15,418) were compared between 1999 and 2017 in the MHHU.ResultsAt the national level, there was an increase in hospital discharges in elderly patients with a significant mean annual percent change of 2.0%. In the study unit, the elderly population were more frequently female, involuntarily admitted, and had a longer hospital stay. They had been diagnosed more frequently with organic and depressive mental disorders, and less frequently with schizophrenia, substance use, and personality disorders.ConclusionsThere was a growing trend in the percentage of elderly psychiatric patients admitted to hospitals during the study period. These results point to the increase in elderly psychiatric admissions and thus the need to adapt psychiatric units to the characteristics of this population.     

Efectividad de la vacuna antigripal en la prevención de la gripe en personas mayores de 65 años

IntroductionInfluenza is one of the diseases with the greatest epidemiological impact and of maximum relevance in the management of health services. The flu vaccine can have great variability each season, so our objective was to find out the effectiveness of the flu vaccine for the 2017/2018 season for the prevention of severe cases of flu in people over 65 years of age in a 385-bed acute general hospital.Material and methodStudy of cases and controls. All hospitalized patients with laboratory-confirmed influenza older than 65 years during the 2017/2018 season were included. Those who met the criteria for a severe case of influenza were considered cases. Those who did not meet the severity criteria were considered controls. Factors associated with the development of severe influenza were calculated.ResultsThe median age was 68 years (SD 91.87). The attack rate was 0.23 per hundred inhabitants and the vaccine effectiveness was 38%. The vaccinated and unvaccinated groups were different in terms of age (p < 0.0481). Vaccination status against severe influenza was found to be an independent protective factor (OR = 0.840; 0.746-0.913).ConclusionsThe effectiveness of influenza vaccination provided greater protection against infection and reduced the severity of influenza in older hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the population at risk.     

Efecto de los movimientos explosivos y de impacto aplicados en piscina sobre la composición corporal,la fuerza y la densidad mineral ósea de mujeres mayores de 60 años

BackgroundOsteoporosis is characterised by loss of bone mass and deterioration of bone tissue microarchitecture that leads to fragility related to the risk of fractures. The aim of the study is to analyse the effects of a training program based on explosive movements and impact, assessed in a swimming pool, on body composition, explosive strength and bone mineral density in women over 60 years old.Material and methodsA total of 35 healthy physically active women (60 ± 4.19 years) were divided into a training pool group using multi jumps (JG) and a control group (CG). JG trained for 24 weeks, 3 times a week, an hour and a half per session. Body composition testing, explosive strength, and bone mineral density were assessed before and after the program.ResultsThere were differences in the explosive force (JG vs CG = P < .05 to .001) and the estimated power (JG vs CG = P < .05 to .002) between JG vs CG, with significant increases in JG. There were no significant differences in the percentage of fat and lean mass, bone mineral density lumbar and femoral between groups, although slightly significant increases in bone mineral density lumbar and femoral could be seen in JG after program implementation (JG pre-test vs JG post- test = P < .05).ConclusionsThe training program with impact and explosive movements assessed in a pool induces gains in muscle strength and power with slight adaptations in body mass index in women over 60 years.     

Expresión sexual y regulación de la sexualidad en residencias de personas mayores

Objectives

The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies.