Validation of the Scale of Perceived Risk of Sexually Transmitted Infections in Middle-aged and Older Adults

Background: Middle-aged and older adults often mistakenly underestimate the risk to which they are exposed when they engage in risky sexual behaviors. Furthermore, a reliable and valid measurement of the construct is necessary to capture its scope and meaning. Objective: To validate the structure of the Perceived Risk Scale for STIs in middle-aged and older adults, identify their perceived risk of STIs, and identify their relationship with some sociodemographic characteristics. Methods: The sample was composed of 295 middle-aged and older adults. A virtual online sampling was used. Males and females aged 50 years and older, sexually active in the last 12 months, were included. To measure the perceived risk of STIs, the scale of perceived risk for human immunodeficiency virus (HIV) was adapted, and a confirmatory factor analysis of the proposed three-factor structure was carried out. Results: The proposed structure of the scale was found to present acceptable adjustment rates (X 2= 48.283, p <.001; CFI = .962, RMSEA = .079, GFI = .963, TLI = .938). 28.1% of the participants presented low perceived risk; 46.8%, medium perceived risk; and 25.1%, high perceived risk. Association between marital status and perceived risk of STIs was identified. Conclusion: The Perceived Risk Scale for STIs is a reliable and valid instrument for capturing perceived risk of STIs in middle-aged and older adults. An appropriate measurement is considered important to accurately examine the relationship between perceived risk and behavior.

Antecedentes: Los adultos de mediana y tercera edad suelen subestimar erróneamente el riesgo al que se exponen cuando realizan conductas sexuales de riesgo, además, es necesaria una medición fiable y válida del constructo para captar su alcance y significado. Objetivo: Validar la estructura de la Escala de Riesgo Percibido a las ITS en adultos de mediana y tercera, identificar su riesgo percibido a las ITS e identificar su relación con algunas características sociodemográficas. Métodos: La muestra estuvo compuesta por 295 adultos de mediana y tercera edad. Se utilizó un muestreo virtual en línea. Se incluyeron hombres y mujeres de 50 años o más, se-xualmente activos en los últimos 12 meses. Para medir el riesgo percibido a las ITS se adaptó la escala de riesgo percibido al Virus de Inmunodeficiencia Humana (VIH) y se realizó un análisis factorial confirmatorio de la estructura propuesta conformada por tres factores. Resultados: Se comprobó que la estructura propuesta de la escala presentaba mostró índices de ajuste aceptables (X2 = 48.283, p <.001; CFI = .962, RMSEA = .079, GFI = .963, TLI = .938). El 28.1% de los participantes presentó un riesgo percibido bajo, el 46.8% un riesgo percibido medio y el 25.1% un riesgo percibido alto. Se identificó la asociación entre el estado civil y el riesgo percibido de ITS. Conclusiones: La Escala de Riesgo Percibido de ITS es un instrumento fiable y válido para captar el riesgo percibido a las ITS en adultos de mediana y tercera edad. Se considera importante una medición adecuada para examinar con precisión la relación entre el riesgo percibido y la conducta.

Latent class growth model-based study of demoralization syndrome among maintenance hemodialysis patients in young and middle-aged adults / 中国实用护理杂志

Objective:To investigate distinct trahectories of demoralization of maintenance hemodialysis patients in young and middle-aged adults, and analyze the factors that affect the trajectory category, so as to provides reference for formulating individualized intervention strategies.Methods:This study was a cross-sectional survey. From April 2020 to April 2021, young and middle-aged maintenance hemodialysis patients fromShangyu People′s Hospital were collected by convenience sampling method and conducted 4-time follow-up investigation. The survey tools included general information questionnaire, Demoralization Scale Mandarin Version (DS-MV) and Experiences in Close Relationship Scale-Short Form (ECR-S). Latent class growth model was used to identify trajectory patterns of demoralization, Logistic regression was used to identify predictors of demoralization trajectories.Results:Totally, 105 patients were enrolled in the present study. Three distinct trajectories were identified and named as "table high level group" 24 cases, "slow reduction group" 39 cases and "continuous reduction group" 42 cases. Univariate analysis showed that age, occupational status, average income per person in family, number of comorbidities, attachment anxiety scores were related to the category of demoralization trajectories ( F = 15.92, χ2 values were 9.16-15.95, all P<0.05). Multivariate Logistic regression analysis showed that age, occupational status, average income per person in family, number of comorbidities, and attachment anxiety scores were important predictors of patterns of demoralization trajectories in young and middle-aged maintenance hemodialysis patients. Conclusions:This study identified three distinct demoralization trajectories in young and middle-aged maintenance hemodialysis patients, clinical nursing should formulate individualized intervention strategies according to the types of patients′ delirium trajectories.

The association between social support and self-rated health in midlife: are men more affected than women? / Associação entre suporte social e autoavaliação de saúde na meia-idade: seriam os homens mais afetados que as mulheres? / La asociación entre el apoyo social y la autoevaluación de salud en la mediana edad: ¿se afectan los hombres más que las mujeres?

Abstract: Social support from family and friends is recognized as an important social determinant of health, given its protective effects on individuals' physical and mental well-being. While most studies have focused on older adults, investigating midlife health is equally crucial since middle-aged individuals are also susceptible to the harmful health outcomes of inadequate social support from friends and family. This study contributes to the debate by examining whether social support is associated with self-rated health among middle-aged Brazilian adults and how this relationship varies between men and women. Using data from the nationwide Brazilian National Health Survey conducted in 2019, logistic regression models were employed to assess differences in self-rated health, accounting for confounding factors. The sample comprised 31,926 middle-aged adults, of which 52.5% were women. The overall prevalence of poor self-rated health was 40.7%, with a significant difference between men and women. Results from this study suggest that having no friends or family members to rely on, both during good and challenging times, was associated with poorer self-rated health. However, the strength of this association differs by gender, with social support from friends playing a more critical role in women's self-rated health. On the other hand, family support was associated with male self-rated health, particularly for men with three or more family members they can rely on. Future studies should consider cultural and contextual factors to better understand other dimensions of social support and its association with midlife health.

Resumo: O suporte social de familiares e amigos é reconhecido como um importante determinante social da saúde com base em seus efeitos protetores sobre o bem-estar físico e mental dos indivíduos. Embora a maioria das pesquisas tenha se concentrado em adultos mais velhos, investigar a saúde na meia-idade é igualmente crucial, já que estes indivíduos também são suscetíveis aos resultados prejudiciais à saúde decorrentes do suporte social inadequado de amigos e familiares. Este estudo contribui para o debate ao examinar se o suporte social está associado à autoavaliação da saúde entre adultos brasileiros de meia-idade e como essa relação varia entre homens e mulheres. Usando dados da Pesquisa Nacional de Saúde realizada em 2019, modelos de regressão logística foram empregados para avaliar diferenças na autoavaliação da saúde, contabilizando fatores de confusão. A amostra foi composta por 31.926 adultos de meia-idade, dos quais 52,5% eram mulheres. A prevalência geral de autoavaliação de saúde ruim foi de 40,7%, com diferença significativa entre homens e mulheres. Os resultados deste estudo sugerem que não ter amigos ou familiares com quem contar em momentos bons ou desafiadores esteve associado à pior autopercepção de saúde. No entanto, a força dessa associação difere de acordo com o gênero, sendo que o suporte social de amigos desempenha um papel mais importante na autoavaliação da saúde das mulheres do que na dos homens. Por outro lado, o apoio familiar esteve associado à autoavaliação da saúde masculina, particularmente para homens com três ou mais membros da família com quem podem contar. Estudos futuros devem considerar fatores culturais e contextuais para compreender melhor outras dimensões do suporte social e sua associação com a saúde na meia-idade.

Resumen: El apoyo social de la familia y de amigos se reconoce como un importante determinante social de salud basado en sus efectos protectores sobre el bienestar físico y mental de los individuos. Aunque la mayoría de las investigaciones se ha centrado en adultos mayores, investigar la salud en la mediana edad también es esencial, una vez que estos individuos también son susceptibles a los resultados perjudiciales para la salud resultantes de un apoyo social inadecuado de amigos e de la familia. Este estudio contribuye al debate al investigar si el apoyo social está asociado con la autoevaluación de salud entre adultos brasileños de mediana edad y cómo esa relación varía entre hombre y mujeres. Usando datos de la Encuesta Nacional de Salud realizada en 2019, se utilizaron modelos de regresión logística para evaluar diferencias en la autoevaluación de salud, contabilizando factores de confusión. La muestra se compuso de 31.926 adultos de mediana edad, de los cuales el 52,5% eran mujeres. La prevalencia general de autoevaluación de mala salud fue del 40,7%, con diferencia significativa entre hombres y mujeres. Los resultados de este estudio sugieren que no tener amigos o familiares en los que confiar en buenos o malos momentos se asoció con la peor autopercepción de salud. Sin embargo, la fuerza de esa asociación es diferente según el género, ya que el apoyo social de amigos es más importante en la autoevaluación de salud de las mujeres que en la autoevaluación de los hombres. Por otro lado, el apoyo familiar se asoció con la autoevaluación de la salud masculina, particularmente para hombres que tenían tres o más personas de la familia en los que confiar. Estudios futuros deben tener en cuenta factores culturales y contextuales para mejor comprender otras dimensiones del apoyo social y su asociación con la salud en la mediana edad.

Incidência de aumento e redução do Índice de Massa Corporal na meia-idade: seguimento de quatro anos / Incidence of increase and decrease in Body Mass Index in middle-aged men and women: four-year follow-up

Resumo Objetivou-se analisar a incidência de aumento e de redução do Índice de Massa Corporal (IMC) entre homens e mulheres de meia-idade segundo características sociodemográficas e classificação do estado nutricional. Trata-se de uma coorte de base populacional com 689 adultos com idade entre 40 e 64 anos seguidos por quatro anos. Verificou-se a proporção de redução e de aumento do IMC (≥1 kg/m²) segundo variáveis sociodemográficas e classificação do estado nutricional na linha de base mediante regressão de Poisson bruta e ajustada. A maior incidência de redução do IMC foi observada entre os homens na faixa etária de 55 a 64 anos (RR: 1,78; IC95%: 1,06-3,00), naqueles sem companheira (RR: 1,85; IC95%: 1,09-3,14), nos classificados com sobrepeso (RR: 2,06; IC95%: 1,13-3,74) e obesidade (RR: 2,33; IC95%: 1,24-4,35), e entre as mulheres na faixa etária de 55 a 64 anos (RR: 1,43; IC95%: 1,02-2,00) e nas classificadas com obesidade (RR: 2,10; IC95%: 1,30-3,38). A incidência de aumento do IMC foi menor na faixa etária de 55 a 64 anos entre os homens (RR: 0,62; IC95%: 0,41-0,95) e mulheres (RR: 0,68; IC95%: 0,49-0,95). Estes dados são importantes para compreensão dos fatores relacionados à variação do IMC e elaboração de políticas públicas que visem o cuidado à saúde na meia-idade.

Abstract The scope of this study was to analyze the incidence of increase and decrease in Body Mass Index (BMI) among middle-aged men and women according to sociodemographic characteristics and classification of nutritional status. It involved a population-based cohort of 689 adults aged 40 to 64 years followed up for four years. The proportion of reduction and increase in BMI (≥1 kg/m²) was verified according to sociodemographic variables and classification of nutritional status in the baseline by means of crude and adjusted Poisson regression. There was a higher incidence of reduced BMI among men in the 55-64 age group (RR: 1.78; 95%CI: 1.06-3.00), in those without a partner (RR: 1.85; 95%CI: 1.09-3.14), in those classified as overweight (RR: 2.06; 95%CI: 1.13-3.74) and in those classified as obese (RR: 2.33; 95%CI: 1.24-4.35), and among women in the 55-64 age group (RR: 1.43; 95%CI: 1.02-2.00) and in those classified as obese (RR: 2.10; 95%CI%: 1.30-3.38). The incidence of increased BMI was lower in the 55 to 64 age group among men (RR: 0.62; 95%CI: 0.41-0.95) and women (RR: 0.68; 95%CI: 0.49-0.95). These data are important for understanding the factors related to the variation of BMI and the elaboration of public policies aimed at the health care of middle-aged adults.

The effect of goat’s milk consumption on the clinical health of middle-aged adults with lactose intolerance

@#Introduction: People with lactose intolerance are suggested to consume dietary items containing less lactose, such as goat’s milk. This study aimed to investigate the effects of goat’s milk powder on the health of lactose intolerant middle-aged adults. Methods: A total of 60 subjects were recruited into this randomised controlled trial. They were divided into four groups and received different dietary interventions (goat’s milk, goat’s milk with curcumin, goat’s milk with coffee, lactose-free milk) for five weeks. Health effects were compared between pre- and post-intervention. Anthropometric and biochemical parameters (blood glucose, insulin, lipid profile, C-reactive protein, and lactoferrin) were evaluated. Dietary intake was recorded using a food record. Results: Fifty-one lactose intolerant subjects completed the study. After ingestion of goat’s milk, there were significant reductions in body fat (p=0.033) and a significant increase in the percentage of muscle (p=0.021). Waist circumference (WC) decreased in both the goat’s milk with curcumin and goat’s milk with coffee groups (p<0.05 for all). Unfortunately, high-density lipoprotein cholesterol (HDL-C) dropped after the five-week intervention in the goat’s milk group (p=0.002). Lactoferrin level of the goat’s milk group was higher than other groups at post-intervention (p<0.001). Besides, the goat’s milk with coffee group seemed to consume more carbohydrates after completing the intervention (p=0.034). Conclusion: A five-week intake of goat’s milk reduced the risk of abdominal obesity among middle-aged adults. In addition, it resulted in improved lactoferrin levels.

Dependencia en adultos mayores con enfermedad de Alzheimer en el Hospital Civil de Tepic, Nayarit, México / Dependence in Aged Adults Suffering from Alzheimer Disease at Tepic Civil Hospital, Nayarit, México

Introducción: El mundo ha experimentado un proceso de cambio que implica múltiples transiciones, como la demográfica y epidemiológica. En México, la prevalencia de las enfermedades demenciales como el Alzheimer tiene una tendencia al aumento, de ahí que sea necesario estudiar y analizar sus repercusiones en la población. Objetivo: Determinar el grado de dependencia en adultos mayores con enfermedad de Alzheimer en un hospital de segundo nivel en Nayarit, México. Métodos: Estudio descriptivo, corte transversal y enfoque cuantitativo. Se aplicó el índice de Barthel para evaluar las actividades básicas de la vida diaria a 29 cuidadores principales de los pacientes registrados en la base de datos del hospital. Las variables elegidas fueron: sexo, edad, municipio y grado de dependencia. El análisis de los datos se realizó mediante el programa SPSS de IBM versión 20. Resultados: La edad media fue de 79 años; el 62,1 por ciento fueron mujeres y el 37,9 por ciento hombres; el municipio con mayor número de pacientes fue Tepic (44,8 por ciento); con respecto al grado de dependencia, la independencia fue la más frecuente (27,6 por ciento), seguido de dependencia total (24,1 por ciento). Se evidenció correlación entre defunciones y grado de dependencia con un nivel de significancia por debajo de 0,000 (error α). Conclusiones. En Nayarit existe dependencia en los adultos mayores con enfermedad de Alzheimer. Los cuidadores primarios reciben poca o ninguna capacitación para el cuidado de estos pacientes. El subdiagnóstico de esta enfermedad de alguna manera favorece la dependencia, pues no se orienta o no se otorgan las medidas básicas terapéuticas a la familia para el apoyo del enfermo, esto a su vez es de especial interés debido a que existe una correlación estrecha entre defunción y dependencia(AU)

Introduction: The world has undergone a process of change that involves multiple transitions, such as demographic and epidemiological. In Mexico, the prevalence of dementia diseases such as Alzheimer's has an increasing trend, hence it is necessary to study and to analyze its impact on the population. Objective: To determine the degree of dependence in aged adults with Alzheimer's disease in a second-level hospital in Nayarit, Mexico. Methods: This is a descriptive study with cross-sectional and quantitative approach. The Barthel index was applied to assess the basic activities of daily living to 29 main caregivers of the patients registered in the hospital database. The variables chosen were sex, age, municipality and degree of dependency. Data analysis was performed using the IBM SPSS version 20 program. Results: The mean age was 79 years; 62.1percent were women and 37.9percent men; the municipality with the highest number of patients was Tepic (44.8percent). Regarding the degree of dependence, independence was the most frequent (27.6percent), followed by total dependence (24.1percent). Correlation between deaths and degree of dependence was evidenced with a level of significance below 0.000 (α error). Conclusions: In Nayarit there is dependence in aged adults suffering from Alzheimer's disease. Primary caregivers receive little or no training in caring for these patients. The underdiagnoses of this disease in some way favors dependence, since the family is not guided or the basic therapeutic measures are not given to support the patient, this in turn is of special interest because there is close correlation between deaths and dependency(AU)

Fracturas de cadera en adultos mayores del Hospital General Agustín O´Horán entre 2015 y 2019 / Hip Fractures in elder Adults at Agustin O´Horán General Hospital from 2015 to 2019

Introducción: El motivo de hospitalización más común en los servicios ortopédicos son las fracturas de cadera, de las cuales, las más frecuentes son las del cuello femoral y pertrocantéreas y/o transtrocantéricas. Existen diversos factores de riesgo entre los adultos de 60 años o más, entre ellos, vivir en una residencia de ancianos, deterioro mental, tipo de fractura, entorno social habitual, y presencia de enfermedades sistémicas asociadas con el envejecimiento. Objetivo: Describir y analizar las fracturas de cadera más frecuentes en adultos mayores en el Hospital General Agustín O´Horán, así como describir la distribución bimestral y anual de los casos ocurridos en el estado de Yucatán. Método: Estudio transversal, descriptivo y retrospectivo que incluyó sujetos de ambos géneros de 60 años y más, que habían ingresado por fractura de cadera entre noviembre 2015 y abril 2019. Se utilizaron las variables género, edad, bimestre, año, ubicación anatómica y tipo de traumatismo, clasificación extracapsular e intracapsular. Resultados: La mayoría de los pacientes fueron del sexo femenino (64,53 por ciento), la edad promedio fue 77,67 años. La fractura con mayor número de casos fue la extracapsular (62,25 por ciento) con su subtipo más prevalente que fue la transtrocantérica (35,78 por ciento). El mayor número de casos se presentó en el año 2016, en los meses de enero a abril hubo mayor número de pacientes ingresados. Conclusiones: Existe una prevalencia de fracturas de cadera en mujeres mayores de 60 años, lo que se corresponde con lo reportado a nivel nacional(AU)

Introduction: The most common reason for hospitalization in orthopedic services are hip fractures, of which the most frequent are those of the femoral neck and pertrochanteric and / or transtrochanteric. There are several risk factors among adults age 60 and over, including living in a nursing home, mental decline, type of fracture, common social environment, and presence of systemic diseases associated with aging. Objective: To describe and analyze the most frequent hip fractures in older adults at Agustin O'Horan General Hospital, as well as to describe the bimonthly and annual distribution of the cases that occurred in the state of Yucatan. Method: Cross-sectional, descriptive and retrospective study that included subjects of both genders aged 60 years and over, who had been admitted for hip fracture from November 2015 to April 2019. The variables were used gender, age, two-month period, year, anatomical location and type of trauma, extracapsular and intracapsular classification. Results: Most of the patients were female (64.53 percent), the average age was 77.67 years. The highest number of cases had extracapsular fracture (62.25 percent), the transtrochanteric subtype was the most prevalent (35.78 percent). The largest number of cases occurred in 2016. January to April there the months with higher number of patients admitted. Conclusions: The prevalence of hip fractures in women over 60 years of age, corresponds to that reported at the national level(AU)

Rol del personal enfermero para modificar el nivel de información en los adultos mayores diabéticos / The Nursing Staff's Role in Modifying the Level of Information in Diabetic Aged Adults

Introducción: La diabetes mellitus se debe a la secreción anormal de insulina y a grados variables de resistencia periférica a la insulina, que conducen a la aparición de hiperglucemia. Objetivo: Evaluar el papel del personal de enfermería para modificar el nivel de información de los adultos mayores diabéticos. Métodos: Estudio de desarrollo tecnológico, contextualizado en el Policlínico Dr. Rudesindo García del Rijo; del Municipio de Sancti Spíritus, en el período comprendido de enero a septiembre del 2019. Variables de estudio: nivel de información, control de la diabetes mellitus, cuidado, estado de salud y factores de riesgo presentes en los adultos mayores con diabetes mellitus. Se utilizó entrevista estructurada para conocer el nivel de información y el cuidado brindado por el personal de enfermería, para la mejoría del estado de salud, se aplicó la escala de Kaff y Lawton. Después de aplicada las acciones de Enfermería se compararon las proporciones poblacionales mediante Test Wilcoxon. Resultados: Los factores de riesgo que más predominaron fueron los antecedentes familiares (87 por ciento) y los hábitos dietéticos inadecuados (84,9 por ciento). El 73,63 por ciento tenía mal nivel de información al inicio; después de aplicar las acciones se enfermería, 60 por ciento obtuvo un nivel de información bueno. Conclusiones: Las acciones de enfermería para modificar el nivel de información en los adultos mayores diabéticos fueron efectivas, al modificar el nivel de conocimientos de los adultos mayores diabéticos, el cuidado y el estado de salud de los pacientes diabéticos que participaron en el estudio(AU)

Introduction: Diabetes mellitus is provoked by abnormal insulin secretion and variable degrees of peripheral insulin resistance, which lead to the onset of hyperglycemia. Objective: To assess the nursing staff role in modifying the level of information of diabetic aged adults. Methods: Study of technological development, contextualized in Dr. Rudesindo García del Rijo Polyclinic of Sancti Spíritus Municipality, in the period from January to September 2019. The study variables were level of information, control of diabetes mellitus, care, health status, and risk factors present in aged adults with diabetes mellitus. A structured interview was used to know the level of information and care provided by the nursing staff; regarding improvement of health state, the Kaff and Lawton scale was applied. After applying the Nursing actions, the population proportions were compared using the Wilcoxon Test. Results: The most prevalent risk factors were family history (87 por ciento) and inappropriate dietary habits (84.9 por ciento). 73.63 por ciento had a bad level of information at the beginning; After applying the nursing actions, 60 por ciento obtained a good level of information. Conclusions: The nursing actions to modify the level of information of aged adults about diabetic adults were effective, in so far their level of knowledge was modified, together with care and health state of the diabetic patients who participated in the study(AU)

A Comparative Study of Problems Faced by the Young- Middle Aged- / Elderly-Adults during COVID Pandemic in Delhi-NCR (National Capital Region)

As the pandemic of COVID-19 has hit the globe, the associated uncertainty is progressively testing the psychological resilience of the masses in India too. Accordingly, the global focus has been mostly on scrutinizing, finding a cure and preventing its transmission; people are facing innumerable psychological problems, adjusting to the current lifestyles and also living in fear of the infection from disease. Since there is a severe dearth of research on this issue, it was decided to conduct an online survey to compare the problems faced by young and middle-aged / elderly adults in the society in Delhi-National Capital Region (NCR) during the lockdown period due to COVID-19. We wanted to analyse and compare the problems faced by young and the middle aged / elderly adults in Delhi NCR during the lockdown period of COVID-19 pandemic. METHODSA total of 450 people had given their consent to participate in this survey through a cross sectional survey during the lockdown period in Delhi-NCR region. Two separate questionnaires were created through google forms and were distributed via WhatsApp groups and other social media platforms. It consisted of 25 questions each based on the problems faced by the young and the middle aged / elderly adults. RESULTSThe study revealed that the young aged and middle-aged / elderly adults were similarly affected due to the lockdown. It also showed that the young adults were concerned to some extent about the studies in the school, college and university through online classes, not able to mix up with their friends for happy hours, getting bored and spending time watching movies / web series, and faced some mood swings due to the restrictions of COVID-19; whereas, the middle-aged / elderly adults were under a fear of getting infected, isolation, work from home, not able to help their relatives, confusion due to change in their routine, losing jobs, and were also upset with the reduction of their salary. CONCLUSIONSBoth the groups were similarly frustrated and stressed but for different reasons during this lockdown and in order to cope with the psychological stress, they should be counselled and given stress relieving sessions or should indulge in updating knowledge, skills etc. by attending to various online webinars, workshops etc.

Fracturas de tobillo en adultos mayores / Ankle Fracture Treatment in Aged Adults

RESUMEN Introducción: El tratamiento de las fracturas del tobillo tiene importancia en la recuperación de la movilidad e independencia del paciente geriátrico. Objetivo: Evaluar el resultado obtenido al transcurrir un año del tratamiento quirúrgico mediante reducción y fijación de las fracturas inestables en pacientes mayores de 65 años. Métodos: Estudio descriptivo y prospectivo; pacientes mayores de 65 años, atendidos entre enero de 2017 y diciembre de 2018 por fractura de tobillo desplazada, en el Hospital Universitario General Calixto García Íñiguez y el Centro de Investigaciones en Longevidad, Envejecimiento y Salud, que fueron evaluados un año después. Resultados: De un total de 31 pacientes, 6 hombres y 25 mujeres con una edad media de 73,4 ± 3,5 años, 12 presentaban deterioro cognitivo, 18 llevaban terapia anticoagulante y 14 ingerían más de cuatro medicamentos diariamente. Predominaron los grupos con 3 y 4 puntos del índice de Charlson, la mayoría se ubicó en ASA III de riesgo anestésico y fracturas Dannis-Weber tipo C, 29 fracturas fueron cerradas. Las complicaciones fueron escasas; 27 de 31 pacientes se ubicaron como excelente o bueno según la escala AOFAS; 3 ± 2 en la escala visual de dolor; 86 por ciento podían realizar sus actividades de la vida diaria, Conclusiones: El resultado del tratamiento quirúrgico de las fracturas de tobillo en mayores de 65 años fue bueno y con baja incidencia de complicaciones que pueden relacionarse con condiciones mórbidas previas(AU)

ABSTRACT Introduction: The ankle fracture treatment is important in the recovery of mobility and independence of geriatric patients. Objective: To evaluate the results after one year of surgical treatment by reduction and fixation of unstable fractures in patients older than 65 years. Methods: A descriptive and prospective study was carried out in patients older than 65 years, treated from January 2017 to December 2018 due to displaced ankle fracture, at General Calixto García Íñiguez University Hospital and the Research Center for Health, Longevity and Aging. These patients were assessed a year later. Results: Out of a total of 31 patients, 6 men and 25 women with a mean age of 73.4 ± 3.5 years, 12 had cognitive impairment, 18 were on anticoagulant therapy and 14 were taking more than four medications daily. Groups with 3 and 4 points of Charlson index predominated, the majority were located in ASA III of anesthetic risk and Dannis-Weber type C fractures, 29 fractures were closed. Complications were rare and 27 out of 31 patients ranked as excellent or good according to the AOFAS scale, 3 ± 2 on the visual pain scale, 86 percent of performing activities of their daily life. Conclusions: The result of the surgical treatment of ankle fractures in people older than 65 years was good and with a low incidence of complications that may be related to previous morbid conditions(AU)

Prevalence of Poor Mental Health and Cognitive Status among Middle-Aged Adults and Its Predictors in Relation to Polyphenols Intake

@#Background: Decline in mental health and cognitive status starts to show its sign during middle-age and is affected by dietary factors, namely the polyphenols intake. Polyphenols have received attention in improving health issues related to aging, including decline in mental health and cognitive. The aim of this study is to determine the prevalence of poor mental health and cognitive status among middle-aged adults and its predictors in relation to polyphenols intake. Methods: Subjects’ food intakes were calculated by using dietary history questionnaire and food frequency questionnaire for polyphenols. The subjects’ mental health and cognitive status were measured by general health questionnaire-28 (GHQ-28) and Rey’s auditory verbal learning test (RAVLT). Results: More than 40% of middle-aged adults were identified as having signs of poor mental health. A total of 67.9% of the subjects had poor cognitive status according to RAVLT immediate recall. Hierarchical binary logistic regression indicated that fat intake was associated with somatic symptoms for both men [adjusted odds ratio (AOR) = 1.04; P < 0.05] and women (AOR = 1.06; P < 0.05). Intake of lignan (AOR = 1.071; P < 0.05) was associated with better RAVLT immediate recall among women. Additionally, high cholesterol (AOR = 3.14; P < 0.05) was associated with poor score of RAVLT delayed recall for women. Conclusions: Early detection of poor mental health and cognitive is crucial to prevent Alzheimer’s disease in old age.

Associations of the eating alone behavior with nutrient intake, obesity and metabolic syndrome in middle-aged adults based on the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined the changes in the nutrient intake and the prevalences of obesity and metabolic syndrome according to the eating alone behavior in middle-aged men and women. METHODS: The data from the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey were analyzed. A total of 7,728 adults (3,404 male, 4,324 female) aged 40 ~ 64 years old were included. The subjects were classified into three groups according to the number of times eating alone per day (0, 1 ~ 2, and 3 times/day). Dietary data were collected by a 1-day 24-h recall. The nutrient intakes were compared among the three groups. Survey logistic regression analyses were conducted to examine the association of the eating alone behavior with obesity and metabolic syndrome, adjusting for the related confounding variables. RESULTS: In men, eating alone was associated significantly with a lower intake of potassium (p-for-trend = 0.048) and lower intake of calories from protein (p-for-trend = 0.04). In women, the proportion of subjects consuming energy less than 75% of the estimated energy requirement (p = 0.001) and less than the estimated adequate requirement of riboflavin (p < 0.001) differed significantly according to the eating alone behavior. The eating alone behavior was positively associated with an increased risk of developing metabolic syndrome (p-for-trend = 0.033), increased blood pressure (p-for-trend < 0.001), and increased waist circumference (p-for-trend = 0.004). On the other hand, in women, however, the eating alone behavior was associated with a decreased risks of developing obesity (p-for-trend = 0.02). No association was found between the eating alone behavior and the risk of metabolic syndrome in women. CONCLUSION: These results suggest that the eating alone behavior is a risk factor for the development of metabolic syndrome in middle-aged Korean men.

Resultados del Examen Periódico de Salud en el Policlínico Universitario Pedro Borrás Astorga / Results of the periodical health check-up in Pedro Borrás Astorga University Polyclinic

Introducción: el examen periódico de salud constituye una herramienta que emplea el médico de familia para iniciar el proceso de evaluación en adultos mayores. Objetivo: describir los resultados del examen periódico de salud. Métodos: se realizó un estudio descriptivo, transversal y retrospectivo en el Policlínico Universitario Pedro Borrás Astorga de Pinar del Río, durante el año 2015, a través de variables seleccionadas. La muestra de estudio estuvo constituida por 7 337 adultos mayores pertenecientes a dicha área de salud y los resultados se expresaron en tablas y gráficos para su mejor comprensión. Resultados: predominó el sexo femenino con 54,6 por ciento, así como el grupo de edad de 65 y más años con 68,6 por ciento. Prevaleció el grupo dispensarial III con 82,6 por ciento fundamentalmente en féminas. El número de exámenes periódicos de salud fueron superiores en el 2015 con 3 806 respecto a años anteriores, donde las afectaciones según escala geriátrica se evidenciaron en el uso de fármacos con 52,2 por ciento. El estado global funcional fue superior al frágil en un 72,6 por ciento. Conclusiones: se caracterizaron los resultados del Examen Periódico de Salud en el Policlínico universitario Pedro Borrás Astorga. El estudio enriquece y amplía el trabajo asistencial, docente, investigativo y gerencial en adultos mayores de dicha área de salud(AU)

Introduction: The periodic health check-up is a tool used by the family doctor to start the evaluation process in aged adults. Objective: To describe the results of the periodic health check-up. Methods: A descriptive, cross-sectional and retrospective study was carried out in Pedro Borrás Astorga University Polyclinic of Pinar del Río, during the year 2015, through selected variables. The study's sample consisted of 7 337 aged adults belonging to the mentioned health area and the results were expressed in tables and graphs for better understanding.Results: The female sex prevailed, with 54.6 percent, as well as the age group of 65 and over, with 68.6 percent. The dispensary group III prevailed, with 82.6 percent, mainly among females. The number of periodic health check-ups was higher in 2015, with 3 806, compared to previous years, in which the effects, according to the geriatric scale, were evidenced in the use of drugs, with 52.2 percent. The global functional state was higher than the fragile one in 72.6 percent. Conclusions: We characterized the results of the periodic health check-up in Pedro Borrás Astorga University Polyclinic. The study enriches and broadens the care, teaching, research and management work in aged adults in this health area(AU)

Bienestar psicológico en función de la etapa de vida, el sexo y su interacción / Psychological Well-being in Terms of Life Stage, Sex, and their Interaction / Bem-estar psicológico em função da etapa de vida, sexo e sua interação

Objetivo. Evaluar las diferencias en las dimensiones del bienestar psicológico en función de los grupos de edad, sexo y su interacción. Método. Se obtuvo una muestra de 706 participantes, dividida en tres grupos de edad (jóvenes, adultos y adultos mayores), quienes respondieron a las escalas de bienestar psicológico de Ryff. Se calculó un Manova teniendo en cuenta las variables grupo de edad, sexo y su interacción. Posteriormente, se realizaron varios Anova para conocer entre cuáles grupos existían diferencias para cada dimensión. Resultados. El análisis mostró una disminución, con la edad, en las dimensiones de bienestar psicológico de relaciones positivas con otros y crecimiento personal, dominio del entorno y pérdida de autonomía en adultos mayores. Por otro lado, la dimensión de autoaceptación difiere entre sexos con la edad; las mujeres mostraron un descenso en su crecimiento personal con la edad, mientras que el dominio del entorno aumenta con la edad adulta, con mayor estabilidad en mujeres. Conclusión. Por lo anterior, se sugiere promover el trabajo de los pensamientos negativos y desadaptativos en mujeres, ya que los hombres obtienen mejores puntuaciones en dimensiones que disminuyen la aparición de patologías relacionadas con el estado de ánimo. Además, deben fomentarse las relaciones sociales y las propias capacidades de los sujetos.

Objective. To evaluate the differences in the dimensions of psychological well-being in reference to age, gender and their interaction. Method. A sample with 706 participants was obtained and then divided in three age groups (young, middle-aged adults and elderly adults), who responded to the Ryff Psychological Well-being Scale A MANOVA was calculated taking into account the group variables of age, gender and their interaction. Later, an ANOVA was done to know among which groups there were differences for each dimension. Results. The analysis showed a decrease, with age, in the dimensions of psychological well-being of positive relationships with others, and personal growth, domain of the environment and loss of autonomy in the elderly adults. In addition, the dimension of self-acceptance differs between the genders with age; women showed a decrease in their personal growth with age, while the domain of the environment increases with the adult age being more stable among women. Conclusion. Based on the above, it is suggested that a work in negative and maladaptive thoughts in women, since men get a better score in dimensions that diminish the appearance of pathologies related to the mood. A work in the social relationships as well as the individuals' aptitudes should be encouraged.

Escopo. Avaliar as diferenças nas dimensões do bem-estar psicológico em função dos grupos de idade, sexo e sua interação. Metodologia. Foi obtida uma amostra de 706 participantes, dividida em três grupos de idade (jovens, adultos e idosos), os quais responderam às Escalas de Bem-estar Psicológico de Ryff. Foi calculado um MANOVA levando em conta as variáveis grupo de idade, sexo e sua interação. Depois, foram feitas ANOVAs para conhecer entre quais grupos existem diferenças para cada dimensão. Resultados. A análise mostrou uma diminuição, com a idade, nas dimensões de bem-estar psicológico de relações positivas com outros e crescimento pessoal, domínio do entorno e perdida de autonomia em idosos. Por sua parte, a dimensão de auto-aceitação difere entre sexos com a idade; as mulheres mostraram um descenso em seu crescimento pessoal com a idade, em quanto que o domínio do entorno aumenta com a idade adulta com maior estabilidade em mulheres. Conclusão. Pelo anterior, sugere-se promover o trabalho dos pensamentos negativos e desadaptativos em mulheres, já que os homens obtêm melhores pontuações em dimensões que diminuem a aparição de patologias relacionadas com o estado de ânimo. Também é recomendável fomentar o trabalho em relações sociais assim como nas próprias habilidades dos sujeitos.

The Association between Dietary Fiber Intake and Prevalence of Metabolic Syndrome in Middle-aged Adults in Gyeonggi Province

BACKGROUND: The aim of this study was to assess the dietary fiber intake of middle-aged adults in Gyeonggi and to evaluate its relation with the metabolic syndrome. METHODS: From April 2013 to October 2014, 279 (60 men, 210 women) middle-aged adults subject older than 30 years of age were recruited. Two-day dietary intake data were collected from each subject using the 24-hour recall method. Metabolic syndrome was diagnosed by anthropometric measurements, blood pressure, and blood analysis. RESULTS: When the subjects were divided into tertile groups by dietary fiber intake per 1,000 kcal, the middle tertile group showed higher fiber intake of 118.8% above the reference intake of 12 g/1,000 kcal, and the highest tertile group showed a higher fiber intake of 165.0% above the reference intake. The group with greater dietary fiber intake showed more mineral and vitamin intake but less energy, fat, and cholesterol intake. The major food groups that contributed to the dietary fiber in the lowest and the middle tertiles were vegetables, grains, fruits, and legumes, but in the highest tertile, legumes contributed more than fruits. The risk of metabolic syndrome (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18-0.77), abdominal obesity (OR 0.45, 95% CI 0.23-0.85,) and hypertriglyceridemia (OR 0.42, 95% CI 0.21-0.83) were significantly reduced in the middle tertile compared to the lowest tertile. CONCLUSIONS: The results suggest that there is a correlation between dietary fiber intake and risk factors for metabolic syndrome. It is highly expected that consuming sufficient amount of fruits and vegetables as a major source of dietary fiber can prevent and manage metabolic syndrome and chronic disease.

Routine Screening and Consultation Facilitate Improvement of Metabolic Syndrome

This randomized controlled trial study aimed to investigate the effects of a lifestyle intervention on metabolic syndrome (MetS) among middle-aged Koreans. A total of 243 middle-aged Koreans with MetS were randomly assigned to either of 2 types of lifestyle intervention for MetS and followed for 12 months. Health examinations and interventions were implemented at 16 regional branch facilities of a Korean medical institution from 2010, following the NCEP-ATP III criteria and recommendations. Lifestyle intervention (LI) group (n = 137) participated in a 12-week multi-component intervention including individual counseling, group sessions, and self-help materials. Basic usual intervention (BI) group (n = 106) was provided with one-page health information sheet on MetS and MetS management at baseline. Prevalence of MetS and each of MetS components, except for low HDL-cholesterol, in both groups were significantly reduced and maintained after the intervention. Notably, prevalence of hypertension and abdominal obesity continued to improve during the follow-up period. Between-group differences in results were not found. Both interventions were effective when they were accompanied with repeated check-ups and notification of MetS status. It is recommended to design clear guidelines for the notification of MetS after MetS screening and to encourage checking MetS status periodically for effective MetS management (KCT 0000446).

The Risk of Metabolic Syndrome by Dietary Patterns of Middle-aged Adults in Gyeonggi Province / 대한지역사회영양학회지

OBJECTIVES: The aim of this study was to assess how nutrient intakes are related to risk factors for metabolic syndrome according to dietary patterns in the middle-aged adults. METHODS: The subjects (n = 187; 47 men, 140 women) consisted of middle-aged adults over 30 years old in Ilsan area. The metabolic syndrome was diagnosed according to the data collected from each subject, including anthropometric measurements and blood analyses. The dietary patterns were derived from the average of two-day dietary intake data. RESULTS: Factor analysis identified three major dietary patterns which were "Meats and alcohol", "Mixed grains, vegetables and fruits", and "Rice, Kimchi and fish & shellfish". The daily intakes of energy, protein, and sodium increased across quartiles of "Meats and alcohol" pattern scores (p < 0.05), whereas the intakes of carbohydrates, potassium, calcium, and fiber increased across quartiles of "Mixed grains, vegetables and fruits" pattern scores (p < 0.001). The "Meats and alcohol" pattern scores were positively correlated with protein and sodium intakes but inversely correlated with carbohydrates, fiber and potassium intakes which were adjusted for age, sex and energy (p < 0.05). The highest quartile pattern score of "Meats and alcohol" pattern had elevated odds ratio of abdominal obesity and metabolic syndrome (p < 0.05). The risk of hypertriglyceridemia decreased in the highest quartile of "Mixed grains, vegetables and fruits" pattern (OR 0.35, 95% CI 0.12-1.00). CONCLUSIONS: Our results suggested that reducing the consumption of meat and alcohol along with increasing fruits, vegetables and mixed grains would be helpful for preventing the metabolic syndrome and chronic diseases.

Study on the relationship between plasma homocysteine and ischemic stroke in young and middle-aged adults / 中国基层医药

Objective To observe the relationship between plasma level of homocysteine(HCY) and ischemic stroke in young and middle-aged adults,explore the clinical signficance concerning the occurrence and development of ischemic stroke in young and middle-aged adults.Methods The plasma homocysteine level of 132 young and middle-aged adults patients with ischemic and 86 control peoples were measured by means of enzymatic cycling assay.Results The plasma homocysteine level in ischemic stroke was higher than that in control group( P ＜ 0.01 ).The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group of young and middleaged adults.The plasma homocysteine level and the infarcted focus was positively linearly correlated.Conclusion Hyperhomocysteinemia is a risk factor of ischemic stroke among young and middle-aged adults.The higher the plasma homocysteine level,the larger infarcted focus in acute ischemic stroke group.The plasma homocysteine level can reflect the size of the infarcted focus and the degree of disease,and the plasma homocysteine level should serve as a kind of regular examination or as an index intervention can be taken,all of which are great importance to prevent ischemic stroke and reduce its morbilily.

Nutritional Environment Influences Hypertension in the Middle-aged Korean Adults: based on 1998 & 2001 National Health and Nutrition Survey / 대한지역사회영양학회지

This study was performed to delineate the relationship between lifestyle and nutritional risk factors associated with hypertension in representative middle-aged Korean population. Hypertension in this study is defined as hypertensive (SBP> or = 140 mmHg or DBP> or = 90 mmHg) adults without recognition of a disease state before a health exam. With data from the 1998 and 2001 National Health and Nutritional Survey, nutrient intakes of 6,112 adults, 40-64 years of age were calculated using food composition database and matched with health examination records by individual ID. After excluding those with extreme intake values, the number of final subjects included in the analysis was 5,200 (male 2,458, female 2,742). Using logistic regression method, socio-demographic data, lifestyle factors, and nutrient intakes were analyzed. Risky factors for hypertension revealed in this study were age, sex, BMI over 23, waist circumference, alcohol intake of more than 16 g (male) or 8 g (female). Regarding nutrient intakes, the intakes of highest quartile for energy (> or = 2363.0 kcal) and protein (> or = 90.2 g) were significantly associated with higher risk of hypertension after adjusting for age, sex, and other socio-demographic factors (OR = 1.312 (1.046-1.711), OR = 1.488(1.194-1.854), respectively)). Although high intakes of sodium (> or = 6604.0 mg) and phosphorus seemed to be risk factors of hypertension also before energy adjustment (OR = 1.278(1.034-1.581), OR = 1.280(1.024 -1.600), respectively), only high intakes of energy and protein remained significant after adjustment. This study revealed that modifying risky lifestyles and dietary patterns, especially high energy intake, high protein intake, and high alcohol drinking, in middle-aged Korean adults could result in a prevalence decrease and/or prevention of hypertension.

COMPARISON STUDY OF PLASMA FOLATE IN CHINESE ADULTS IN GENDERS AND AGES / 营养学报

Objective: To describe the differences of plasma folate concentration and prevalence of folate deficiency in genders and ages in Chinese adults aged 35 to 64 years. Methods: By cross-sectional analysis, plasma folate concentration was measured in 2 545 adults including men and women by microbiological assay. Results: (1) Men tended to have lower plasma folate concentration and higher prevalence of folate deficiency(9.70 nmol/L, 31.0%) than did women(14.2 nmol/L, 12.5%, P=0.001). (2) Men in South have significantly higher plasma folate concentration and lower prevalence of folate deficiency than in North. The difference of plasma folate concentration was not evident between urban and rural area, but evident in North between in winter and spring. There were no significant differences of prevalence of folate deficiency for men between urban and rural areas in both regions. For women, the differences of plasma folate concentration in areas were significant, which were higher in South and urban, and lower in North and rural areas. (3) Plasma folate concentration increased with age in Southern men. A similar trend for others was not significant. Conclusion: Men have lower plasma folate concentration and higher prevalence of plasma folate deficiency than do women. The distribution of plasma folate concentrations in urban and rural areas seems different between men and women.