Revisión sistemática de aceptación de la tecnología digital en personas mayores. Perspectiva de los modelos TAM

In this study, a systematic review of researches published about the determining factors in the intention of the use of devices and digital technology in older adults has been carried out. The technology acceptance model is the framework used. The main result of the analysis of 60 scientific articles published between 2010 and 2020 has been summarized after a bibliographic research and a subsequent selection process in the most important bibliographic databases: Web of Science (n = 45), Scopus (n = 66) and Google Scholar (n = 224). It has been proved the predominance of quantitative studies with a prevalence of study factors that associate the intention to use technology with: Facilitating conditions, experience, health, social support, emotions, perceived enjoyment, perceived satisfaction in using technology, anxiety, perceived risk, motivation, cost, subjective norm and social influence. The results of the systematic review allow us to conclude the urgent need to incorporate new research on the identification and influence of these factors that stand between older adults and technology, as possible barriers or facilitators of use.     

Prevalencia de los trastornos de ansiedad en las personas mayores de 65 años: una revisión sistemática

Anxiety is an emotional problem that causes discomfort and suffering to those that suffer from it. Anxiety disorders can affect the functioning in different facets of a person's life. Studies on the prevalence of anxiety disorders in people over 65 years show variable results, ranging between 0.1% and 17.2%. Most of these studies include samples of the general population, in which the population of people over 65 years is under-represented. These studies evaluate older people with the same diagnostic tools used to assess anxiety disorders in people under 65 years, and collect data from people between 65 and 75 years old, leaving out people aged 75 and over. A systematic review of the prevalence studies of anxiety disorders in elderly people is presented. It is concluded that when representative samples of people over 65 years are used and evaluated with suitable tools, the prevalence rate of these disorders in the elderly is much higher than previously thought, reaching an annual prevalence rate of 20.8%.     

¿En qué personas mayores,dónde y cómo se está aplicando el ejercicio multicomponente para obtener beneficios en su salud? Una revisión sistemática

The aim of this systematic review was to synthesise the characteristics of older adults (OA) and to give an account of how and when multicomponent exercise (MCE) has been used to improve physical and psychological health, as well as their cognitive function. This systematic review was conducted on 21 articles published in PsycINFO, Medline, and Web of Science databases from 2009 to 2019, using the procedures set out in the PRISMA statement. The total sample consisted of 3,768 older adults with a mean age of 74.2. More than three-quarters (76%) of the articles studied older adults that lived in the community. evidenced Frailty was observed in the subjects in 23.8% of the articles. In 76% of the studies, a health professional was responsible for the program. Just under half (48%) of the studies were carried out in places equipped for exercise. The most frequent parameters used were two weekly 45 to 60-minute-long sessions for six months. The most frequent variables for physical health, psychological health, and cognitive function were muscle strength, social function, and memory, respectively. To assess physical health, psychological health, and cognitive function, the most frequent tools used were the timed up and go test (TUG), the geriatric depression scale (GDS), and the mini-mental state examination (MMSE), respectively. It was concluded that there is an age and health profile of OA who participate in MCE. The parameters and times most frequently used in MCE, along with the most frequently used parameters and times were recorded. In addition, the variables of interest, and the tools used to evaluate the effects of MCE on physical and psychological health and cognitive functions, were identified.     

Efectividad del entrenamiento interválico de alta intensidad en la capacidad cardiorrespiratoria de personas mayores de 65 años,una revisión sistemática

The objective of this review was to analyze the effect of HIIT on cardiorespiratory fitness, health-related quality of life (HRQL) and safety of its execution in people over 65 years of age.A systematic search was carried out, following the PRISMA recommendations, in 11 electronic databases, evaluating the resolution of the HIIT, affecting cardiorespiratory capacity as the main result and secondarily HRQL and safety of its execution, assessing the risk of bias using Rob 2.0 and ROBINS-I.Thirteen studies met the inclusion criteria, consisting of people >65 years, HIIT intervention >4 weeks, and studies assessing cardiorespiratory fitness.It can be concluded that HIIT improves cardiorespiratory capacity in people over 65 years of age, with respect to HRQL and the safety of its execution, the results are not conclusive. It becomes essential to unify criteria in intervention protocols, requiring further research in this regard.     

Anciano y anemia: revisión crítica de su definición y prevalencia

Background and objectivesThe prevalence of anaemia is an important health indicator, although there is little rigorous information gathered on the elderly population, particularly in those over 80 years old. The same criteria that are used in the general population are often used to define anaemia in the elderly. The epidemiological data collected by the WHO in 1968 (that have been used to generalise this criteria), did not include the population over 65 years-old.Two objectives are established, which includes a critical review of the available evidence on whether the criteria used to define anaemia in the adult population can be extrapolated to the elderly, and a review of publications on the prevalence of anaemia in the elderly over 80 years-old.Material and methodsA systematic bibliographic search was performed on the established objectives.ResultsAlthough the WHO criteria, based on data from 1968, are widely used, other possible cut-off points have been proposed for elderly people. A total of 20 studies were found that were conducted in North America and Europe, with only 70,000 patients, and different age criteria. The prevalence of anaemia ranges between 3% and 63%, depending on the diagnostic criteria, age, and whether they were institutionalised or not.ConclusionsAnaemia is a very prevalent disease in elderly patients. The collection of large databases is necessary to determine more adequate diagnostic criteria.     

Análisis de biopsias líquidas para el diagnóstico del cáncer: revisión sistemática

The incidence of cancer has increased in recent years, especially in those over 65 years of age, posing a major health problem. Many tumours have a poor prognosis because they are diagnosed at very advanced stages. It is therefore especially important to incorporate liquid biopsy into clinical practice as a method for detecting tumours at very early stages. A systematic review was conducted, with the main objective of analysing the available literature on the use of liquid biopsy in the early diagnosis of cancer, and as a secondary objective, to determine the types of tumours that can be diagnosed early by liquid biopsy and the available biomarkers. The results indicate a lack of agreement with the biomarkers detected and the technologies applied. This highlights the need for multicentre studies to look at large cohorts and to establish protocols of action, as well as to increase analytical validity and the possibility of using a screening test for each type of tumour. This could be a very important step forward, as it could improve the management of cancer patients to a great extent.     

La depresión y su relación con el deterioro cognitivo leve y la enfermedad de Alzheimer. Un estudio de revisión sistemática

The objective of the present study was to determine whether depression precedes Mild cognitive impairment (MCI) as a risk factor or as a predictor in Alzheimer's disease (AD). A systematic review of observational studies (cross-sectional and cohort or follow-up) was carried out using the PRISMA search algorithm, for clinical markers in MCI and AD, in the Science Direct, Springer, Scopus and Proquest databases. The study eligibility criteria included inclusion criteria: of types of documents, articles of primary studies, type of source scientific journals, published in the English language, from January 2010 to April 2020, in patients with MCI and AD and in the group of age included in people with a minimum age range of 45 years. Exclusion criteria were: publications older than 10 years because the aim of the article was to explore recent studies, secondary research studies, type of report document, languages other than English. 3385 articles were identified, of which 30 articles were finally selected. It was found that there is an association between depression and AD, but properly as a risk factor but not, as a predictor or clinical marker of the development of AD. The degree of association is greater when they present depressive symptoms and simultaneously report subjective memory complaints or the presence of MCI.     

Efectos de la actividad física de intensidad suave sobre las condiciones físicas de los adultos mayores: revisión sistemática

Physical activity can improve function in people over 65. The aim of the study was to evaluate the efficacy of mild intensity exercise interventions on the functional health and quality of life of this population. A systematic review was conducted using WOS (n = 20), Scopus (n = 235), PubMed (n = 15), and PEDro (n = 20) databases. Eight studies met the inclusion criteria. Six hundred and nineteen subjects with an age range of 60-103 years were evaluated. Interventions included endurance, aerobic, and vibration exercises. Those who used pedometers, telephone calls and follow-up controls showed positive effects in increasing physical activity. Five studies evaluated strength and showed that increasing strength also improved balance and walking speed. The results indicate that applying mild intensity physical activity interventions is a way of ensuring improved functional health and quality of life in older people.     

Diabetes mellitus y riesgo de fractura de cadera. Revisión sistemática

Background and objectivesIt has been reported that the risk of fracture is increased in patients with diabetes mellitus (DM). The aim of this study was to investigate the possible relationship between DM and hip fracture, as well as any associated risk factors, by means of a systemic review of the literature.MethodsPubMed and SCOPUS databases were used to search for relevant studies published from January 2001 to August 2018. Retrospective and prospective cohort studies were selected in which the estimated risk of hip fracture was demonstrated by comparing groups of diabetic patients with non-diabetics. A search was also made for risk factors independent from the association between DM and hip fracture.ResultsA total of 27 articles that fulfilled the inclusion criteria were included. A clear association was observed in diabetic patients (women and men) compared to non-diabetics patients. Among the risk factors, the most important ones were the fact that diabetes was type 1, probably associated with greater risk to a longer duration of DM, and being a female.ConclusionsThere is an increased risk of hip fracture in patients diagnosed with DM. This association is more significant in diabetes type 1 and women.     

Factores de riesgo asociados a desnutrición en personas mayores que viven en la comunidad: una revisión rápida

The aim of this review was to determine the most important risk factors (RF) in the development of malnutrition in people over 65 years living in the community. A rapid review has been conducted by applying the PRISMA methodology (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) and using the Medline database (PubMed). A search strategy was drawn up, up to 13 January 2020. A total of 24 articles published in the last 5 years were included in this review. Assuming the methodological limitations of the present review, it is possible to conclude that undernutrition is a multifactorial problem whose most significant RF are: age, economic status, alterations in the digestive system, comorbidity, polymedication, dependence on the performance of daily life activities, physical inactivity, food insecurity, depression, social isolation, and the field of self-perceptions. Early identification of geriatric patients exposed to these RF can allow a preventive approach in the development of malnutrition from primary care.     

Impacto de la pandemia por COVID-19 y el confinamiento estricto de la población en la incidencia de fractura de cadera en España. Una revisión sistemática

Background and objectiveDuring the COVID-19 pandemic, a strict population confinement was decreed in Spain. In a situation of health crisis and health system saturation, knowledge of pathologies whose treatment cannot be delayed is of great importance for the correct management of resources and processes. The objective was to determine the influence of the COVID-19 pandemic and the strict population confinement on hip fracture incidence in Spain.Material and methodSystematic review following the PRISMA guidelines. Search in Pubmed and Chocrane Library on 11/11/2022: hip fracture and COVID-19 and Spain.ResultsSix studies met the inclusion criteria, 50% showed a decrease in the hip fractures incidence during strict population confinement (all in Comunidad de Madrid hospitals), and in the other 50% there were no differences (all in other region hospitals). It was constant that hip fractures, either did not decrease, or decreased much less than the rest of fractures during the period of strict population confinement, increasing their relative number with respect to the total admissions in orthopedic surgery and traumatology.ConclusionsThe behavior of the hip fractures number during the strict population confinement decreed by the COVID-19 pandemic has not been symmetrical in all regions. To design and implement contingency plans in the event of a pandemic situation, these data must be taken into account in order to properly plan material and human resources.     

Condiciones sociodemográficas ambientales asociadas a perfiles de salud-alimentación entre personas adultas mayores,Córdoba-Argentina

IntroductionDemographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities.ObjectiveTo analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020.MethodologyEpidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews.ResultsThe average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25 kg/m²). The presence of obesity (BMI≥30 kg/m²) was associated (OR = 2.05; CI 1.007–3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation.ConclusionThe predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process.     

Inmunosenescencia,infecciones virales y nutrición: revisión narrativa de la evidencia científica disponible

Aging of the immune system, or immunosenescence, alters the viral immune response in the elderly, especially when frailty exists. Research findings have demonstrated an imbalance in pro- and anti-inflammatory mechanisms, reduced production and diversification of T lymphocytes, and an alteration in immunovigilance and antibody synthesis. In this context, nutrition has a role in combating sarcopenia and frailty. Some food components that contribute to immune-competence are protein, vitamin D, n-3 fatty acids, antioxidant vitamins (vitamins C and E), zinc, selenium and iron. In times of a pandemic, nutritional recommendations for immune-competence in the elderly should be based on clinical studies. In this article, immunosenescence and its relationship to nutrition are addressed, including interventions studied in the context of the COVID-19 pandemic.     

Atención psicomédica a personas transexuales en España en la era de la despatologización de la transexualidad como trastorno mental. Una revisión global

ObjectiveTo identify the strengths and weaknesses of Spanish healthcare protocols for transsexual persons and to compare them to current international protocols. To review the current status as regards transsexuality etiology and prevalence. To suggest measures to optimize care to achieve a significant improvement, including options for saving financial resources.MethodsA comparison of the contents of texts related to transsexualism in the ICD-10, DSM-IV, and guidelines of the Spanish gender units with international standards of care for transgender persons and the last draft version of the DSM-5. Systematic revision of the literature related to the etiology and prevalence of transsexualism.ResultsSignificant discrepancies have been found as regards the minimum time period for diagnosis, access to hormone replacement therapy and to genital surgery, and the requirement of the so-called real-life experience. Impact of sex hormones on the etiology of transsexualism and underestimation of its prevalence was confirmed.ConclusionsThe access to hormonal and surgical treatment requires a profound review, and decentralization of transsexual care is recommended, because all university hospitals haves psychiatrists, clinical psychologists, and endocrinologists available. Although gender reassignment surgery also requires plastic surgery specialists, plastic surgeons currently receive training in this field.