La eclosión de la sarcopenia: Informe preliminar del Observatorio de la Sarcopenia de la Sociedad Española de Geriatría y Gerontología

Sarcopenia is a common and prominent geriatric syndrome, of major interest for daily clinical practice of professionals working with older people. The number of affected individuals and its relation with disability, frailty, many chronic diseases, lifestyle and adverse outcomes are extremely relevant for geriatric care. Moreover, biological changes that lead to the loss of muscle mass and strength are intrinsically related to the mechanisms of aging. It is not therefore surprising that research in this field is growing exponentially in recent years, and sarcopenia has been placed in recent years in the forefront of research in geriatric medicine and gerontology.The Spanish Society of Geriatrics and Gerontology has recently created an Observatory of Sarcopenia, which aims to promote educational and research activities in this field. The first activity of the Observatory has been to offer the Spanish speaking scientific community a review of the current status of sarcopenia, that may allow unifying concepts and fostering interest in this promising field of geriatrics.     

El fenómeno de las caídas en residencias e instituciones: revisión del Grupo de Trabajo de Osteoporosis,Caídas y Fracturas de la Sociedad Española de Geriatría y Gerontología (GCOF-SEGG)

The Workshop on Osteoporosis, Falls and Fractures (GCOF) of The Spanish Geriatrics and Gerontology Society (SEGG) formed a committee in order to review the state of the art on the detection, risk factors and assessment tools for falls, and intervention protocols when falls occurs in nursing homes, long-term hospitals or medium-stay units. The different patient profiles are described in order to make a comprehensive approach to this heterogeneous topic and population, offering a risk classification and specific advice according to these categories.     

Efectos del ejercicio físico en la funcionalidad y calidad de vida en mayores institucionalizados diagnosticados de gonartrosis

Introduction

At present, aging and increased life expectancy implies a greater susceptibility to dependence, which then leads to the irreversible loss of quality of life, in many cases due to chronic diseases such as osteoarthritis (OA). The aim of this study was to determine the effect of a treatment based on aerobic exercise in institutionalised elderly people diagnosed with knee osteoarthritis.

Material and method

An experimental, prospective, single blind study was conducted. The sample (n = 31), was divided into two groups. The experimental group (n = 17) was treated based on aerobic exercise for 4 weeks with 2 sessions per week and each lasting 50 minutes. We conducted a pre-test and post-test assessment using a visual analogue scale, WOMAC questionnaire and SF-36 as measuring instruments. The statistical program SPSS15.0 was used for the analysis of the data.

Results

We obtained significant differences in the t-test for paired samples in the three dimensions of the WOMAC questionnaire, P<.001, in the perceived pain P<.001 and in the physical function, vitality and mental health dimensions of the SF-36 with a 95% confidence interval.

Conclusion

Exercise gave positive results in functional (pain, stiffness, physical function) and psychological aspects (mental health and vitality) in the institutionalised elderly.     

Geriatría y cuidados paliativos: algunas reflexiones

This article attempts to provide a framework for reflection on the relationships between 2 close specialties, such as geriatrics and palliative care. In medicine today, with the progressive ageing of the population, 80% of deaths occur at a very advanced age, and a high percentage of these are potentially likely to receive palliative care in their final stages. The reflections offered in this presentation are made from a perspective of someone who has always worked in the geriatrics field. Throughout this article, some the common points in the historic evolution of both specialities are made and discussed. The inter-relationships and common ground in other fields may be, their form of understanding medical care, clinical objectives, doctrinal bases, the work methodology, or the overlapping of some elements of training. Several aspects of where they differ on these same points are also discussed. It is concluded with a call for collaboration between the specialists of both fields, as well as in the need to demand that the health administrations introduce larger palliative teams in all hospitals in the country.     

Conodontos carboníferos de la sección del río Cares (Unidad de Picos de Europa, Zona Cantábrica, NO de España)

The first Carboniferous conodonts studied from the Cares river section correspond to fifteen species and one subspecies from seven genera, some of them reported from the Picos de Europa Unit for the first time. The conodonts belong to several zones between the upper Tournaisian and the upper Serpukhovian-lower Bashkirian. Furthermore, the species Idiognathodus incurvus Dunn is reported for the first time in the Cantabrian Mountains and southern Europe, from upper Bashkirian or lower Moscovian beds.     

Tafonomía y contexto paleoambiental de los restos de un cetáceo del Mioceno medio de Tarragona (NE España)

A new finding of a marine mammal is documented from the middle Miocene of El Camp basin in Tarragona (NE Spain). The incomplete and disarticulated bone remains belong to the skeleton of a juvenile cetacean. These remains appear deposited above a transgression surface and included within a glauconitic calcisiltite layer. This unit constitutes the beginning of a shallowing-upwards sequence and was deposited under low-energy conditions and low sedimentation rates in a middle-outer platform setting. This context was responsible for the long exposure of the remains and, consequently, an extension of the biostratinomic stage. These conditions favored the natural decomposition and disarticulation of the carcass, allowing the action of different types of scavenging organisms. The interpretation of the paleoenvironmental setting is based in the combination of different datasets: taphonomic data of the bone remains, paleoecologic and taphonomic information provided by the fauna associated to the bones, and ichnologic and sedimentologic interpretation of the sediments where the fossils are included. Combination of such different proxies enables a very good characterization of the paleoenvironmental context of the studied fossils.     

Filicales y Bennettitales del Cretácico Inferior de Carazuelo, provincia de Soria, España

Silicified woods of the fern Tempskya riojana Barale and Viera and the Bennettitales Cycadeoidea barbarae Crisafulli nov. sp., found together with undetermined conifer woods, from the NW of Carazuelo, province Soria, are described. This site is located south of the so-called San Saturio fault which runs parallel to Road N-234. The fossil trunks are included in the “Conglomerados poligénicos, areniscas y arcillas” fluviatile sediments, dated as Paleogene. The original source of these fossils could be Tera and/or Oncala Groups, both Early Cretaceous in age and outcropping close by at Fuentetecha, Fuensaúco and North of Soria. Similar plant fossil findings from this region are reported and some mistakes in the geological mapping are analyzed. The Tempskya specimens were histologically poorly preserved, but had enough anatomical characters to be undoubtedly assigned to Tempskya riojana. The new species Cycadeoidea barbarae is described, with fairly well preserved cellular structure, viz., pith, vascular cylinder, cortex, foliar/branch traces, as well as strobili surrounded by foliar scales and apical seminal cones. An important and new aspect of the new species is that it includes morphologically and anatomically preserved both fructifications and vegetative parts, whereas these are usually find separated by other species of Bennettitales.     

Paroniceratinae (Ammonoidea, Hildoceratidae) del Toarciense en las Cordilleras Ibérica y Cantábrica (España)

The Paroniceratinae constitute a group widely recorded in the Tethys realm. However, they represent alone a small part, less than 1%, of the ammonoidea obtained in Toarcian sediments from the regions located at the east of the Iberian Plateau (Iberian Range). The values are yet smaller in the northern regions (Cantabrian Range) and in the west (Portugal), and show a sporadic presence in the Betics Ranges. In this study, the biostratigraphical distribution and the biochronostratigraphical position of the recorded species in the more representative expanded sections of Spain are checked and compared with those of other areas of the NW Europe bioprovinces and of the Tethys. The obtained specimens from Frechiella: F. subcarinata (Young and Bird), F. helenae Renz, F. venantii (Catullo), F. kammerkarensis (Stolley) and F. cf. octaviae Renz are described and figured, all of them proceeding from sediments of the Bifrons Zone in the Iberian Range, as well as those of Paroniceras: P.sternale (d’Orbigny) and P.helveticum Renz, and Oxyparoniceras: O. (O.) cf. telemachi (Renz), O. (O.) buckmani (Bonarelli), O. (N.) cf. undulosum (Monestier), O. (N.) cf. morbiense (Renz) and O. (N.) cf. brocardi Rulleau, Bécaud and Neige, proceeding from sediments of the interval between the Bifrons Zone (Semipolitum Subzone) and the Insigne Zone (Insigne Subzone), in the Iberian and Cantabrian Ranges. The Frechiella and Oxyparoniceras species are developed and recorded in the Iberian Plateau margins during the Bifrons Zone and the Insigne Zone, respectively, during the same intervals than the transgressive maxima of the LJ3 and LJ4 second order cycles recognized in all the studied area, while Paroniceras species make it during the Variabilis Zone, that concur with the final regressive stage of the LJ3 cycle.     

Características antropométricas,funcionales y de fuerza explosiva de mujeres mayores de 50 años físicamente activas de la ciudad de Bogotá, Colombia

Objective

To analyze the relationship between different test measuring explosive strength and functionality of active women participating in a leisure sport program in order to describe the caracteristics of health status and look for tools for diagnosing and monitoring degenerative process.

Methods

This study was conducted on 102 women physically active and without risk factors. Anthropometric, functional independence and explosive strength tests were applied.

Results

Mean age 60.08±5.35 years; body mass index: 26.81±3.91; percentage of fat: 52.45±4.75; percentage of muscle mass: 37.24±6.77; tests of functional independence: maximum speed (30 meters): 9.39±1.92 s; speed-agility (30 meters): 12.93±1.59 s, and dynamic balance (6 meters): 21.9±8.01 s. Explosive Strength (Bosco test): Squat Jump: 12.23±3.05 cm, Countermovement Jump: 13.18±3.04 cm and Countermovement Jump Arm swing: 14.80±4.01 cm.

Conclusion

The statistical relationships found between body composition, explosive strength and functionality tests, are important tools for diagnosing and monitoring, and could improve the intervention models on the elderly.     

1. Reunión Nacional de Trabajo Multidisciplinar en Oncogeriatría: documento de consenso

On 2nd of June 2011 the Institut Català d’ Oncologia l’Hospitalet--Hospital Duran i Reynals hosted the first Meeting of Multidisciplinary Work in Oncogeriatrics. The reason for the meeting, which follows on from an initiative of the Medical Societies of Radiotherapy, Oncology, Geriatrics and Gerontology and Palliative Care and Medical Oncology, was to initiate a joint line of work among the different specialties that generally take part in the handling of the elderly patient suffering from oncologic pathologies. This document summarises the different subjects covered during the Meeting.     

Propuesta de una batería neuropsicológica para la exploración del síndrome de Capgras

Capgras syndrome is the most prevalent of the delusional misidentification syndromes. It appears in both psychiatric illness and organic brain damage. Cognitive and neuropsychiatric models (lateralization and disconnection) have been proposed to explain the syndrome. From a neuropsychological point of view Capgras syndrome seems to be due to damage of bifrontal and right limbic and temporal regions. Memory, feeling of familiarity, monitoring of self and reality would be altered. All of these cause a failure to adequately integrate the information about emotions and facial recognition. Relative preservation of the left frontal lobe may be necessary for the development of delusional response. There does not seem to be a differential pattern as regards the aetiology, but there is a common underlying neuropsychiatric mechanism. Based on theoretic models, and clinics features, we propose a neuropsychological battery to assess the Capgras syndrome, that should be sensitive to the main expected deficits.     

Tafonomía de bivalvos holocenos en la costa del estuario de Bahía Blanca, Argentina

In the Bahía Blanca Estuary (Argentina), Holocene deposits are fossiliferous sand ridges originated by the last transgressive-regressive marine event. By means of ternary taphograms applied on valves of Brachidontes rodriguezi a taphonomic analysis was carried out in two ridges, both in the external and internal estuary area. Six taphonomic attributes were considered. The disarticulation and the fragmentation are higher in the external ridge, whereas the bioerosion and incrustation, both barely manifested, are similar in the two environmental settings. In the outer deposit, as much the abrasions as the dissolution of the shells are more intense. Genetically, it is considered that these shell concentrations were originated by multiepisodic storm events. Based on the taphonomic analysis, it arises that in the generation of the internal ridge waves of moderate energy with different sorting degrees prevailed, whereas in the formation of the external deposits waves of greater energy with smaller sorting capacity prevailed.     

Prevalencia y factores asociados a sospecha de malos tratos en la unidad geriátrica del área de urgencias del hospital

Objective

To know the prevalence of mistreatment and to identify the associated factors among elderly people without cognitive impairment, seen in the geriatric unit, located in the hospital emergency area.

Methods

Cross-sectional study of a population of 65 years or older assessed by the geriatric Interdisciplinary Social Welfare Functional Unit (ISSFU) of the emergency area in the Arnau de Vilanova hospital of Lleida. We excluded participants with cognitive impairment. The total number of participants was 127. The suspicion of mistreatment was measured using the Questionnaire of the American Medical Association (AMA) and the Canadian Task Force (CTF). The variables studied were social demographic characteristics and functional dependency.

Results

Prevalence of suspicion of mistreatment was 29.1% (95% CI: 0.21-0.37). The most frequent subtypes were neglect and psychological, and less frequent was negligence. Associated factors were being female, being in unpaid work, being a widow and living alone.

Conclusions

Three out of ten elderly people were identified as possible victims of abuse. Due to the relative isolation of many of the elderly who were abused, an unexpected visit to the emergency area may be the only opportunity for detection. Geriatric units located in this area should include the suspicion of mistreatment of this population in their comprehensive assessment. For this, it is necessary to have tool with a high degree of sensitivity and specificity for detection of abuse in the elderly.     

Estructuras de escape y equilibrio asociadas a Conichnus conicus como indicadores de tasas de sedimentación variables en medios litorales tortonienses del SO de España

Numerous and large vertically extensive specimens of Conichnus conicus are described from the Tortonian deposits of the central Guadalquivir Basin (SW Spain). These burrowing structures form a low bioturbation index of the ichnofabric, which allows one to infer the original depositional setting. Both ichnological and sedimentological features suggest a coastal to shallow marine environment dominated by high sediment supply and high-energy sedimentary processes. Conichnus exhibits a characteristic internal fabric that reflects changes in sedimentation rates linked to various processes: (1) initial substrate penetration by the tracemaker; (2) gradual retrusive movement in response to rapid but continuous sediment aggradation; 3) moderate to high rates of retrusive migration as a consequence of rapid to very rapid sediment aggradation and tracemaker escape; and, finally, (4) abandonment of the burrow or burial of the tracemaker subsequently in response to extremely high sediment accumulation rates. Conichnus has been also described from other areas with similar deposits of different ages, where its important value as a paleoenvironmental indicator similarly has been indicated.     

Elaboración de una herramienta para la estimación del riesgo de mortalidad a corto y medio plazo tras el alta de una Unidad de Hospitalización de Agudos de Geriatría

Objectives

To identify predictive factors for 6 and 12-months mortality after discharge from a geriatric acute care unit, and from these, derive a mortality-risk index.

Methods and analysis

Prospective cohort study will be conducted on patients over 70 years-old admitted to a geriatric acute care unit and survived to hospital discharge. The main outcome measure will be mortality at 6 months and 12 months after discharge. Independent variables include sociodemographics, functional status, comorbidities, and clinical and laboratory characteristics. Risk factors associated with mortality will be constructed using multivariate logistic regression models. To build the mortality index, points will be assigned to each risk factor by dividing each beta coefficient in the logistic model by the lowest beta coefficient. A score will be assigned to each subject by adding up the points for each risk factor present in the model. The predictive accuracy of the model will be determined by comparing the predicted versus observed mortality in the study population and calculating the area under the ROC curves in both populations.

Conclusions

The risk-mortality index developed would allow an easy estimate to be made of individual risk of death at 6 months and 12 months after discharge from a geriatric acute care unit, with the purpose of establishing care plans and individualising treatment, according to real objectives.