ABSTRACT
Introducción. Los síntomas depresivos en los pacientes mayores hospitalizados son muy frecuentes, y se han asociado a una mayor mortalidad. Nos planteamos estimar la prevalencia de los síntomas depresivos en los ancianos hospitalizados y su relación con distintas afecciones, así como con su situación funcional, mental y mortalidad. Material y métodos. Se estudiaron prospectivamente 115 pacientes mayores de 64 años. Se utilizó la escala de depresión geriátrica de Yesavage en su versión de 15 ítems validada en español. Se consideró la presencia de los síntomas depresivos si se obtenían de 6 o más puntos. Se recogieron las características demográficas, el índice de comorbilidad de Charlson, los diagnósticos de ingreso, la situación funcional evaluada mediante el índice de Barthel y de Lawton-Brody, la capacidad mental evaluada mediante el cuestionario de Pfeiffer, la estancia y la mortalidad hospitalaria. Resultados. De los 115 pacientes estudiados con una edad media de 70,5 años, 71 (61,7%) eran mujeres. Se observaron síntomas depresivos en 46 pacientes (40%; IC 95%: 34,8-43,9). Los pacientes que fallecieron mostraron una puntuación significativamente superior en la prueba de Yesavage (p = 0,04). En el análisis multivariante se observó la asociación significativa independiente entre los síntomas depresivos y la capacidad funcional (p = 0,026), la capacidad mental (p = 0,021), la insuficiencia renal (p = 0,001), la hepatopatía (p = 0,018) y la artrosis (p = 0.017), perdiéndose la significación obtenida previamente para la diabetes (p = 0,43). Conclusiones. La prevalencia de síntomas depresivos en los ancianos hospitalizados es elevada, y se asocia con los diagnósticos de insuficiencia renal, hepatopatía y artrosis, con una mayor comorbilidad y especialmente con una peor capacidad funcional (AU)
Introduction: Depressive symptoms in hospitalized patients are very common, and they have been related to higher mortality. The aim of the study was to estimate the prevalence of depressive symptoms in hospitalized elderly patients and its relationship to various diseases, as well as their functional and mental status and mortality. Material and methods: A total of 115 patients over 64 years of age were prospectively studied. The validated Spanish version of the Geriatric Depression Scale of Yesavage (15-item version) was used. Patients were considered to have depressive symptoms if >=6 points were obtained. The demographic characteristics, the Charlson comorbidity index, the diagnosis at admission, the functional status assessed by the Barthel and Lawton-Brodie index, the mental capacity assessed by the Pfeiffer questionnaire, the length of the hospital stay, and hospital mortality were recorded. Results: Out of the 115 patients studied, with a mean age of 70.5 years, 71 (61.7%) were female. Depressive symptoms were observed in 46 patients (40%, 95% CI: 34.8-43.9). Patients who died showed a significantly higher score on the Yesavage scale (P=.04). The multivariate analysis showed a significantly independent association between depressive symptoms and functional capacity (P=.026), mental status (P=.021), renal failure (P=.001), liver disease (P=.018), and osteoarthritis (P=.017), but losing the previously seen significant association with diabetes (P=.43). Conclusions: The prevalence of depressive symptoms in hospitalized elderly patients is high, and is associated with the diagnoses of renal failure, liver disease and osteoarthritis, with a higher comorbidity and especially with a poorer functional capacity (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Depression/complications , Depression/diagnosis , Depression/psychology , Health Services for the Aged/standards , Health Services for the Aged , Stroke/complications , Stroke/epidemiology , Stroke/prevention & control , Depression/epidemiology , Depression/prevention & control , Psychiatric Status Rating Scales/statistics & numerical data , Psychiatric Status Rating Scales/standards , Prognosis , Comorbidity , Prospective Studies , Surveys and Questionnaires , Confidence Intervals , Logistic ModelsABSTRACT
INTRODUCTION: Depressive symptoms in hospitalized patients are very common, and they have been related to higher mortality. The aim of the study was to estimate the prevalence of depressive symptoms in hospitalized elderly patients and its relationship to various diseases, as well as their functional and mental status and mortality. MATERIAL AND METHODS: A total of 115 patients over 64 years of age were prospectively studied. The validated Spanish version of the Geriatric Depression Scale of Yesavage (15-item version) was used. Patients were considered to have depressive symptoms if ≥6 points were obtained. The demographic characteristics, the Charlson comorbidity index, the diagnosis at admission, the functional status assessed by the Barthel and Lawton-Brodie index, the mental capacity assessed by the Pfeiffer questionnaire, the length of the hospital stay, and hospital mortality were recorded. RESULTS: Out of the 115 patients studied, with a mean age of 70.5 years, 71 (61.7%) were female. Depressive symptoms were observed in 46 patients (40%, 95% CI:34.8-43.9). Patients who died showed a significantly higher score on the Yesavage scale (P=.04). The multivariate analysis showed a significantly independent association between depressive symptoms and functional capacity (P=.026), mental status (P=.021), renal failure (P=.001), liver disease (P=.018), and osteoarthritis (P=.017), but losing the previously seen significant association with diabetes (P=.43). CONCLUSIONS: The prevalence of depressive symptoms in hospitalized elderly patients is high, and is associated with the diagnoses of renal failure, liver disease and osteoarthritis, with a higher comorbidity and especially with a poorer functional capacity.
Subject(s)
Depression/epidemiology , Aged , Female , Hospital Mortality , Humans , Male , Middle Aged , Prevalence , Prospective StudiesABSTRACT
Objetivos: Comparar la estimación de eventos cardiovasculares fatales con las funciones de Framingham y SCORE, además de explorar su capacidad para detectar el riesgo aportado por factores no incluidos en sus ecuaciones: sedentarismo, obesidad, perímetro abdominal, razón abdomen/estatura, razón abdomen/pelvis y consumo excesivo de alcohol. Métodos: Estudio transversal de 5.289 personas, de 30 a 69 años de edad, obtenidas por muestreo aleatorio en la población general de Canarias. Se calibraron las funciones de Framingham y SCORE, y se estimó su concordancia. Se obtuvo, para estas edades, la tasa poblacional de mortalidad cardiovascular y se confrontó con el riesgo predicho por las funciones. Resultados: En los hombres, la tasa de mortalidad por 100.000 habitantes fue de 67,4, en tanto que la estimación de Framingham, SCORE-Low y SCORE-High fue de 80, 140 y 270, respectivamente. En las mujeres, frente a una tasa de 19,3, la estimación fue de 30, 50 y 70, respectivamente. Ambas funciones detectaron el incremento del riesgo aportado por los factores estudiados, con la excepción, en las mujeres, del sedentarismo con SCORE y del consumo excesivo de alcohol con ambas funciones. En los hombres, tomando para Framingham los puntos de corte de >12%, >15% y >20%, la concordancia con SCORE-Low produjo una Kappa de 0,6, 0,7 y 0,5, respectivamente. Conclusiones: La función de Framingham estimó mejor las tasas de mortalidad que la función SCORE. Únicamente la función de Framingham detectó en ambos sexos el riesgo cardiovascular aportado por el sedentarismo. En Canarias recomendamos la aplicación de la función de Framingham calibrada (AU)
Introduction: To compare the performance of the Framingham and SCORE functions to estimate fatal cardiovascular events. In addition, we explored the ability of both functions to detect the risk contributed by factors not included in their equations: sedentariness, obesity, abdominal circumference, abdomen/height razón, abdomen/pelvis ratio, and excessive alcohol consumption. Methods: We performed a cross-sectional study of 5,289 individuals aged 30 to 69 years old, recruited by random sampling of the general population of the Canary Islands. We calibrated the Framingham and SCORE functions and estimated their concordance. The cardiovascular mortality rate for the population in this age range was compared with the risk predicted by the two functions. Results: Among males, the mortality rate per 100,000 inhabitants was 67.4, while the Framingham, SCORE-low and SCORE-high estimations were 80, 140, and 270, respectively. Among females, the mortality rate was 19.3 while the estimations were 30, 50, and 70, respectively. Both functions detected the increased risk contributed by the factors studied, except for sedentariness among females with SCORE, and excessive alcohol consumption with both functions. Among males, taking cut points of > 12%, > 15%, and > 20% for Framingham, the concordance with SCORE-low yielded Kappa values of 0.6, 0.7, and 0.5, respectively. Conclusions: The Framingham function yielded the best estimate of cardiovascular mortality rates. Only Framingham detected the cardiovascular risk contributed by sedentariness in both genders. We recommend the use of the calibrated Framingham function for this population (AU)
Subject(s)
Humans , Risk Adjustment/methods , Cardiovascular Diseases/mortality , Mass Screening/analysis , Risk Factors , Sedentary BehaviorABSTRACT
INTRODUCTION: To compare the performance of the Framingham and SCORE functions to estimate fatal cardiovascular events. In addition, we explored the ability of both functions to detect the risk contributed by factors not included in their equations: sedentariness, obesity, abdominal circumference, abdomen/height razón, abdomen/pelvis ratio, and excessive alcohol consumption. METHODS: We performed a cross-sectional study of 5,289 individuals aged 30 to 69 years old, recruited by random sampling of the general population of the Canary Islands. We calibrated the Framingham and SCORE functions and estimated their concordance. The cardiovascular mortality rate for the population in this age range was compared with the risk predicted by the two functions. RESULTS: Among males, the mortality rate per 100,000 inhabitants was 67.4, while the Framingham, SCORE-low and SCORE-high estimations were 80, 140, and 270, respectively. Among females, the mortality rate was 19.3 while the estimations were 30, 50, and 70, respectively. Both functions detected the increased risk contributed by the factors studied, except for sedentariness among females with SCORE, and excessive alcohol consumption with both functions. Among males, taking cut points of > or = 12%, > or = 15%, and > or = 20% for Framingham, the concordance with SCORE-low yielded Kappa values of 0.6, 0.7, and 0.5, respectively. CONCLUSIONS: The Framingham function yielded the best estimate of cardiovascular mortality rates. Only Framingham detected the cardiovascular risk contributed by sedentariness in both genders. We recommend the use of the calibrated Framingham function for this population.
Subject(s)
Cardiovascular Diseases/mortality , Risk Assessment/methods , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Spain/epidemiologyABSTRACT
INTRODUCTION AND OBJECTIVES: To compare different definitions of a sedentary lifestyle and to determine which is the most appropriate for demonstrating its relationship with the metabolic syndrome and other cardiovascular risk factors. METHODS: A cross-sectional study of 5814 individuals was carried out. Comparisons were made between two definitions of a sedentary lifestyle: one based on active energy expenditure being less than 10% of total energy expenditure, and the other, on performing less than 25-30 minutes of physical activity per day. Reported levels of physical activity, anthropometric measurements, and biochemical markers of cardiovascular risk were recorded. The associations between a sedentary lifestyle and metabolic syndrome and other risk factors were adjusted for gender, age and tobacco use. RESULTS: The prevalence of a sedentary lifestyle was higher in women (70%) than in men (45-60%, according to the definition used). The definitions based on physical activity duration and on energy expenditure were equally useful: there were direct associations between a sedentary lifestyle and metabolic syndrome, body mass index, abdominal and pelvic circumferences, systolic blood pressure, heart rate, apolipoprotein B, and triglycerides, and inverse associations with high-density lipoprotein cholesterol and paraoxonase activity, which demonstrated the greatest percentage difference between sedentary and active individuals. An incidental finding was that both definitions of a sedentary lifestyle were more strongly associated with the metabolic syndrome as defined by International Diabetes Federation criteria than by Adult Treatment Panel III criteria. CONCLUSIONS: Given that it is relatively easy to determine whether a patient performs less than 25 minutes of physical activity per day, use of this definition of a sedentary lifestyle is recommended for clinical practice. The serum paraoxonase activity level could provide a useful marker for studying sedentary lifestyles.
Subject(s)
Energy Metabolism , Life Style , Motor Activity , Adult , Cross-Sectional Studies , Female , Humans , Male , Metabolic Syndrome/diagnosis , Risk Factors , Terminology as Topic , Time FactorsABSTRACT
Introducción y objetivos. Comparar 2 definiciones diferentes de sedentarismo y averiguar cuál es más efectiva para detectar su relación con el síndrome metabólico (SM) y otros factores de riesgo cardiovascular. Métodos. Estudio transversal de 5.814 individuos. Se compara el concepto de sedentarismo basado en consumir activamente menos del 10% del gasto energético total con el concepto basado en no realizar al menos 25-30 min diarios de ocio activo. Se analizan la actividad física declarada, la antropometría y los marcadores bioquímicos de riesgo cardiovascular. La relación del sedentarismo con el SM y los marcadores de riesgo se ajustó por el sexo, la edad y el tabaquismo. Resultados. La prevalencia de sedentarismo en mujeres (70%) fue superior a la de los varones (un 45-60%, según el concepto empleado). El tiempo de ocio mostró la misma efectividad que la energía consumida: el sedentarismo se asoció directamente con el SM, el índice de masa corporal, las cinturas abdominal y pélvica, la presión arterial sistólica, la frecuencia cardiaca, la apolipoproteína B y los triglicéridos, e inversamente con el colesterol unido a lipoproteínas de alta densidad (cHDL) y la actividad de la paraoxonasa (ésta presentó el mayor porcentaje de variación entre sedentarios y activos). Como resultado colateral se obtuvo que la definición de SM propuesta por la Federación Internacional de Diabetes se asocia con mayor fuerza que la del ATP-III a cualquier concepto de sedentarismo. Conclusiones. Dada su mayor facilidad de obtención, en la práctica clínica es recomendable el uso del concepto de sedentarismo basado en averiguar si el paciente realiza al menos 25 min diarios de ocio activo. La actividad de la paraoxonasa es un marcador de interés para el estudio del sedentarismo
Introduction and objectives. To compare different definitions of a sedentary lifestyle and to determine which is the most appropriate for demonstrating its relationship with the metabolic syndrome and other cardiovascular risk factors. Methods. A cross-sectional study of 5814 individuals was carried out. Comparisons were made between two definitions of a sedentary lifestyle: one based on active energy expenditure being less than 10% of total energy expenditure, and the other, on performing less than 25-30 minutes of physical activity per day. Reported levels of physical activity, anthropometric measurements, and biochemical markers of cardiovascular risk were recorded. The associations between a sedentary lifestyle and metabolic syndrome and other risk factors were adjusted for gender, age and tobacco use. Results. The prevalence of a sedentary lifestyle was higher in women (70%) than in men (45-60%, according to the definition used). The definitions based on physical activity duration and on energy expenditure were equally useful: there were direct associations between a sedentary lifestyle and metabolic syndrome, body mass index, abdominal and pelvic circumferences, systolic blood pressure, heart rate, apolipoprotein B, and triglycerides, and inverse associations with high-density lipoprotein cholesterol and paraoxonase activity, which demonstrated the greatest percentage difference between sedentary and active individuals. An incidental finding was that both definitions of a sedentary lifestyle were more strongly associated with the metabolic syndrome as defined by International Diabetes Federation criteria than by Adult Treatment Panel III criteria. Conclusions. Given that it is relatively easy to determine whether a patient performs less than 25 minutes of physical activity per day, use of this definition of a sedentary lifestyle is recommended for clinical practice. The serum paraoxonase activity level could provide a useful marker for studying sedentary lifestyles
Subject(s)
Male , Female , Adolescent , Adult , Middle Aged , Aged , Humans , Energy Metabolism/physiology , Metabolic Diseases/complications , Life Style , Metabolic Diseases/physiopathology , Biomarkers , Blood Pressure/physiology , Tobacco Use Disorder/adverse effects , Body Mass IndexABSTRACT
No disponible
Subject(s)
Aged , Humans , Dental Care for Aged/methods , Dental Care for Aged/standards , SpainABSTRACT
No disponible
