Medida de la capacidad funcional y la calidad de vida relacionada con la salud de un grupo de personas mayores que llevan a cabo un programa de caminatas: estudio piloto

Introduction

This pre-experimental study analyses the Functional Capacity (FC), Body Mass Index (BMI), Health Related Quality of Life (HRQoL) and Health Capital Stock (HCS) of elderly people participating in a Walking program in Granollers (Barcelona).

Material and methods

One hundred and seventy-three participants were invited to participate. One hundred and one of them were users of the Municipal Program for Elderly People, and 72 received information by the communication media. One hundred and thirty-one (76.3%) of the participants completed the Program.The intervention consisted of a 6-month program, supervised by a specialist instructor once a week and controlled daily by a pedometer.The 6-minute walk test (6MWT) was analysed for the FC, and the EuroQoL for the HRQoL. The preferences derived from the EuroQoL scores and the Life Expectancy were used to calculate the FC. The monetary data were obtained using a fixed value.

Results

An increase in the average number of steps was observed after the program, especially in men. The results also showed a decrease in the BMI. The participants showed a improvement in overall health perception at the end of the program. The HCS scores confirmed the improvement in the HRQoL in men.

Conclusions

The Program was positive for increasing the number of steps and improving physical condition and health. The usefulness of the pedometer as a motivational tool of physical exercise is discussed.     

La desesperanza como predictora de la soledad en adultos mayores

Background and objectiveHopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.Material and methods138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD = 4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.ResultsThe motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R² adj = .442, F(3, 87) = 23.97, p < .001.ConclusionsLoneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.     

Presencia y representación de las personas mayores en la publicidad televisiva: el caso español

Introduction

The demographic shift towards aging population generates a series of socioeconomic and cultural changes that are beginning to transform the role and public image of older people. The elderly have become one of the market segments with a greater future. This fact has attracted little scientific interest in the field of advertising communication and for this reason there is little research that is actually looking into this Spain. This research examines the use that is made of the image of the elderly in the television advertising in Spain, looking at the differences between the advertisement dedicated to the targeting people over 65, and those that are not directed at the elderly, but use older people in their content as actors or main characters in the advertisement.

Material and methods

A content analysis study was conducted on a sample of 2,065 spots obtained from prime time slots (from 20:30 to 22:30 p.m.) from the five major Spanish television channels (TVE 1, La 2, Tele 5, Antena 3 and Cuatro). Two independent judges coded all the advertisements. The reliability coefficient between judges was 0.91.

Results and conclusions

In general, older people, particularly women, are not very often shown in Spanish advertising. Their presence is much stronger and visible in campaigns which aim their communication strategy at different age groups. In those cases, advertising presents the elderly with a stereotyped, self-interested and traditional image.     

Retos y oportunidades en el estudio de vesículas extracelulares: contexto institucional a nivel mundial y situación actual en Colombia

In the last decade, the number of studies and publications on extracellular vesicles (EV) and exosomes has boomed. Colombia has displayed interest and progress in their study as shown in the increase of research project publications and products. However, this research field is still developing and has its own analytical challenges and technical limitations. For planning research projects and developing EV studies it is necessary to consider what is the state of the scientific field worldwide concerning EV nomenclature and classification, available techniques, resources, requirements and quality specifications, and the institutions that regulate the field. Answering this question will elicit EV studies that comply with international standards and respond to institutional demands and recommendations. However, the scientific information available is scattered and not all the aspects are considered in full.In this update, the available information is condensed and the official terms and currently defined nomenclature is presented, as well as the evolution of the field, the homogenization of the experimental parameters, the establishment of scientific authorities, institutions, and resources, and the recommendations generated worldwide for their development and research including their isolation, characterization, and functional studies. Finally, I analyzed the national context in a critical way, considering institutional strengths, common mistakes, and available analytical techniques and technologies.     

Calidad de vida percibida por las personas mayores. Consecuencias de un programa de estimulación cognitiva a través de la motricidad «Memoria en movimiento»

Introduction

This article presents the results of evaluation of health related quality of life in a group of elderly people who were engaged in the program of cognitive stimulation «Memory in movement».

Materials and methods

A content analysis was conducted to determine the type of experience that the subjects stated in the context of an interview. The statements were classified into categories created ad hoc. The sample consisted of 32 participants with a mean age of 69.92 ± 4.98 years. The software QSR NVivo-8 was used for data processing.

Results

The results show that the 48% of the elderly perceive some improvements in their memorisation abilities, 47% in attention and concentration, and 10% in the satisfaction with life after being in the program. They are especially worried about the loss of memory -stated by the 65.62%- and they came to the cognitive stimulation program with the aim of improving this capacity. The feelings that participants reported having experienced during the program have to do with fun, vitality and energy.

Conclusions

Programs on cognitive stimulation that incorporate some physical activities, together with a clear playful and social component, improve the psychic and social capacities and they open an important line of intervention due to their good acceptance by the elderly.     

Factores asociados a la polifarmacia en población anciana no institucionalizada. Análisis de la submuestra de la Encuesta Nacional de Salud 2006 para personas mayores de Castilla y León

Background

The increase in chronic and degenerative diseases in the elderly leads to increased and multiple drug usage, which in turn leads to problems associated with adverse reactions and drug interactions.

Material and methods

We analysed the subsample of the National Health Survey 2006, for adults over 65 living in Castile-León (n = 458). Using a logistic regression model and correlation analysis the variables having more influence on polypharmacy were evaluated.

Results

A total of 86% of those interviewed claimed to be taking drugs and 93.9% had a chronic illness. The most common health problems included arthrosis, arthritis or rheumatism (53.5%) and hypertension (48.3%), and most frequently used drugs were hypotensives (45%), pain medications (37.1%) and those for rheumatism (21.4%). Both the mean number of illnesses suffered and the drugs consumed are significantly higher in those who claimed to have, “or or fair health, used the health services, had impaired eyesight and hearing, dependent for personal care and domestic tasks, and mobility (P < .05). The variables associated with polypharmacy are three or more chronic diseases (OR = 18.3), regular-poor self perceived health (OR = 3.4) and females (OR = 1.9).

Conclusions

Given the magnitude of the problem it would be appropriate to include a review of the medications in health examinations of the elderly, particularly in women older than 75 years, with regular or self-perceived poor health and who have 3 or more diseases.     

Efectos de un programa de intervención neuropsicológica basado en mindfulness sobre la enfermedad de Alzheimer: ensayo clínico aleatorizado a doble ciego

Introduction

The purpose of this research was to assess effects of a mindfulness based neuropsychological intervention on the clinical course of Alzheimer's disease.

Material and method

A two year randomized and double blind clinical trial was conducted on 127 probable Alzheimer's disease patients, according to NINCDS-ADRDA scale. Patients were grouped into three experimental groups (cognitive stimulation, progressive muscular relaxation, and mindfulness) plus a control group. All participants were receiving donepezil. Cognitive skills were assessed with CAMCOG and MMSE, functional area with RDRS-2, and NPI was used for psychopathology screening. Three treatment sessions per week were carried out for two years, and follow up measurements were taken every six months.

Results

The global cognitive function, functionality and behavioral disorders measurements indicated that patients from the experimental group based on mindfulness were stable during the two years, while patients from the control group, as well as the other experimental groups, showed a mild but significant worsening of their mental capacities.

Conclusion

The mindfulness based neuropsychological program showed better cognitive and functional stability, as well as significant improvement in the psychopathological condition of mild to moderate Alzheimer’ patients. These results support the idea that a mindfulness based intervention can produce a clinically relevant improvement in the treatment of dementia. More research is needed to confirm these data.     

Fractura de odontoides en un paciente anciano con mala evolución final: a propósito de un caso y revisión de la bibliografía existente

Odontoid fractures are the most common cervical spine fracture in elderly patients, with falls being the most common mechanism of fracture in these patients. The clinical symptoms range from mild neck pain to quadriplegia, or even death. Treatment options include surgical and non surgical therapies, such as cervical collar or halo vest.     

Eficacia de la vía subcutánea frente a la hidratación intravenosa en el paciente anciano hospitalizado: estudio controlado aleatorizado

Introduction

The subcutaneous (SC) route has recently emerged as a rehydration method with potential advantages in the geriatric population. Nevertheless, little is known about its application during hospitalization. The objective of the present study is to evaluate the subcutaneous non-inferiority efficacy in hydration against the intravenous (IV) route in elderly patients with dehydration.

Material and methods

A prospective, randomized and controlled interventional trial of patients 65 years and older admitted to an Acute Geriatric Unit with mild to moderate dehydration and oral intolerance, evaluating the non-inferiority of subcutaneous fluid therapy versus the intravenous route. The intervention consisted of the administration of up to 1.5 l/day/route for 72 hours subcutaneous vs. intravenous, evaluating the variations in biochemical parameters (urea, creatinine, osmolarity), clinical outcome, and route related complications.

Results

Sixty seven patients completed the study (34 SC, age 86.4±8.5 years, 41% women, vs. 33 IV, 84.3±6.6, 54.5% women, with no significant differences). The amount of fluid administered per day by route was 1.320 ml±400 SC vs. 1.480 ml±340 IV, P=.092. During follow similar reductions were observed between groups without any statistical significance, with mean differences pre-postintervention of urea (49.6±52.3 SC vs. 50.3±52.3 IV, P=.96); creatinine (0.68±0.66 SC vs. 0.60±0.49 IV, P=.58), and osmolarity (15.6±24.4 SC vs. 21.1±31 IV, P=.43). Fewer catheter extraction episodes were observed in the SC group, which also was the group most prone to peri-clysis edema.

Conclusions

The efficacy of subcutaneous rehydration in elderly hospitalized patients with mild-moderate dehydration is not inferior to that obtained intravenously, and may even have additional advantages.     

Documento de posicionamiento: evaluación y manejo de la hipoglucemia en el paciente concon diabetes mellitus. Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición

ObjectiveTo provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus.ParticipantsMembers of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition.MethodsRecommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group.ConclusionsThe document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus.