Association of regional muscle strength with mortality and hospitalisation in older people.

BACKGROUND: the association between muscular strength, mortality and hospitalisation with ageing can change depending on sex and the body region analysed (e.g. upper and lower limb muscles). OBJECTIVE: to determine the effect of measuring lower and upper extremities muscular strength on the relationship between strength, mortality and hospitalisation risk in elder men and women. DESIGN: a population-based cohort study using data from the Toledo Study for Healthy Aging (TSHA). METHODS: a Spanish population sample of 1,755 elders aged ≥65 years participated in this study. Upper (handgrip and shoulder) and lower limbs (knee and hip) maximal voluntary isometric strength was obtained using standardised techniques and equipment. Cox proportional hazards model was used to examine mortality and hospitalisation over 5.5 and 3 years of follow-up, respectively. RESULTS: after adjustment for potential confounding factors, including co-morbidities and BMI, hazard ratio of death and hospitalisation was significantly lower in the stronger women and men, but showing regional- and sex-specific differences. That is shoulder, knee and hip muscle regions in women and handgrip and shoulder in men (all P < 0.05). There was a cumulative effect of measuring several muscle strengths over the risk of health events (P < 0.05), so that mortality hazard ratio increased by 45% in women and 25% in men per muscular strength (shoulder, grip, knee and hip) in the weaker strength quartile increase (P < 0.01). CONCLUSIONS: regional muscle strength is a predictor of medium-term mortality and hospitalisation in elder men and women. Multiple strength measures including lower and upper body limb muscles are better predictors than a single strength measurement.

Trastornos de la conducta alimentaria y la personalidad. Un estudio con el MCMI-II / Eating behaviour disorders and personality. A study using MCMI-II

ObjetivoEstudiar las características de personalidad en pacientes con trastornos alimentarios y la influencia de dichas características y ciertos síndromes clínicos en la evolución de esos trastornos, especialmente cuando cursan durante más de 7 años.DiseñoEstudio de comorbilidad mediante prueba diagnóstica.EmplazamientoPacientes ambulatorios en unidad de trastornos alimentarios.Participantes147 pacientes con trastornos alimentarios, en tratamiento ambulatorio, con peso normal. Media de edad, 22,24 años.IntervencionesValoración de personalidad y síndromes clínicos mediante el Inventario de Millon (MCMI-II).Mediciones principalesMedias en las escalas de personalidad y síndromes clínicos; determinación de prevalencia mediante una tasa-base >84.ResultadosEn pacientes con anorexia se detecta al menos un trastorno de personalidad en el 25,33%; en bulimia nerviosa llega al 30,44% y en el trastorno por atracón al 32,13%. En formas purgativas la prevalencia es del 31,07% y en no purgativas, del 24,75%. En la anorexia el trastorno obsesivo es el más frecuente (39,77%); en bulimia lo es el trastorno histriónico (46,66%); en las formas purgativas, el trastorno dependiente (46,15%), y en no purgativas, el obsesivo (35,36%). Considerando las puntuaciones medias, resultan significativamente más elevadas en pacientes con bulimia para el trastorno histriónico (p<0,05). En estos pacientes también se observa más sintomatología histeriforme (p<0,01) e hipomanía (p<0,05). Finalmente, en pacientes con más de 7 años de evolución se recoge más ansiedad (p<0,05), neurosis depresiva (p<0,05) y abuso de alcohol (p<0,01).ConclusionesValorar los estilos de personalidad y síndromes clínicos asociados a los trastornos alimentarios parece de suma importancia terapéutica y pronóstica(AU)

ObjectiveTo study the personality characteristics in patients with eating behaviour disorders and the influence of these characteristics, and certain clinical syndromes on the progress of these disorders, particularly when they have lasted more than seven years.DesignStudy of comorbidity using a diagnostic test.SettingEating behaviour disorders unit outpatients.ParticipantsA total of 147 patients with eating behaviour disorders being treated as outpatients. They were of normal weight, with a mean age of 22.24 years.InterventionsAssessment of personality and clinical syndromes using the Millon Clinical Multiaxial Inventory (MCMI-II).Main measurementsMeans of the personality and clinical syndromes scales and determination of prevalence using a rate-base >84.ResultsAt least one personality disorder was detected in 25.33% of patients with anorexia, 30.44% with bulimia nervosa and 32.13% with binge-eating disorder. In the purgative and non-purgative forms the prevalence was 31.07% and 24.75%, respectively. An obsessive disorder is more common in anorexia (39.77%); a histrionic disorder in bulimia (46.66%); a dependent disorder in the purgative forms (46.15%), and an obsessive one in the no-purgative forms (35.36%). As regards the mean scores, they were significantly higher in patients with bulimia for the histrionic disorder (P<.05). More hysterical type symptoms and hypomania were also observed in these patients (P<.01 and P<.05, respectively). Finally, the patients who had suffered the disorder for more than seven years registered more anxiety (P<.05), depressive neurosis (P<.05) and alcohol abuse (P<.01).ConclusionsTo assess personality styles and clinical syndromes associated with eating behaviour disorders can be an important therapeutic and prognostic tool(AU)

[Eating behaviour disorders and personality. A study using MCMI-II]. / Trastornos de la conducta alimentaria y la personalidad. Un estudio con el MCMI-II.

OBJECTIVE: To study the personality characteristics in patients with eating behaviour disorders and the influence of these characteristics, and certain clinical syndromes on the progress of these disorders, particularly when they have lasted more than seven years. DESIGN: Study of comorbidity using a diagnostic test. SETTING: Eating behaviour disorders unit outpatients. PARTICIPANTS: A total of 147 patients with eating behaviour disorders being treated as outpatients. They were of normal weight, with a mean age of 22.24 years. INTERVENTIONS: Assessment of personality and clinical syndromes using the Millon Clinical Multiaxial Inventory (MCMI-II). MAIN MEASUREMENTS: Means of the personality and clinical syndromes scales and determination of prevalence using a rate-base>84. RESULTS: At least one personality disorder was detected in 25.33% of patients with anorexia, 30.44% with bulimia nervosa and 32.13% with binge-eating disorder. In the purgative and non-purgative forms the prevalence was 31.07% and 24.75%, respectively. An obsessive disorder is more common in anorexia (39.77%); a histrionic disorder in bulimia (46.66%); a dependent disorder in the purgative forms (46.15%), and an obsessive one in the no-purgative forms (35.36%). As regards the mean scores, they were significantly higher in patients with bulimia for the histrionic disorder (P<.05). More hysterical type symptoms and hypomania were also observed in these patients (P<.01 and P<.05, respectively). Finally, the patients who had suffered the disorder for more than seven years registered more anxiety (P<.05), depressive neurosis (P<.05) and alcohol abuse (P<.01). CONCLUSIONS: To assess personality styles and clinical syndromes associated with eating behaviour disorders can be an important therapeutic and prognostic tool.

Ejercicio físico, conducta alimentaria y patología / Physical activity, eating behavior, and pathology

Se ha descrito una importante actividad física en pacientes con trastornos alimentarios y la hiperactividad llega a estar presente en más del 80 por ciento en las fases graves. El inicio de la restricción alimentaria se produce a edades más tempranas cuando existe ejercicio físico intenso, la insatisfacción corporal es mayor entre pacientes practicantes de ejercicio y la presencia de actividad intensa en la anorexia precede a la dieta restrictiva. El objetivo de nuestro estudio fue evaluar la presencia de ejercicio al inicio del trastorno, y las posibles diferencias en la modalidad, según edad, sexo y subgrupos diagnósticos. La evaluación del ejercicio de los pacientes (N = 745), se hizo a través de la entrevista Eating Disorders Examination (EDE). Se recogió la presencia o no de actividad física conducente al consumo calórico, la pérdida de peso o la modificación de la figura, tipo de actividad e intensidad. Se consideró sólo la presencia de intensidad moderada o alta, y con clara relación con los objetivos mencionados. 407 pacientes (54,63 por ciento) realizaban ejercicio:68,96 por ciento en anorexia, 68,96 por ciento en bulimia y 34,73 por ciento en los trastornos no especificados, sin diferencias significativas entre hombres y mujeres. La hiperactividad fue lo más frecuente, (47,42 por ciento), seguida de la actividad en gimnasio (25,79 por ciento). Considerando los diferentes diagnósticos observamos diferencias significativas. La correcta evaluación del ejercicio excesivo es fundamental en los trastornos alimentarios a fin de incluir dicho aspecto en los programas de tratamiento.

Intense physical activity has been reported in patients with eating disorders, and hyperactivity can be found in more than 80 percent in severe stages. The beginning of food restriction occurs at earlier ages if there is an intense physical activity; body dissatisfaction is more intense among patients who practice exercise; and the presence of intense activity in anorexia nervosa usually precedes to the restrictive diet. The aim of this study was to evaluate the presence of exercise at the beginning of the eating disorder, and to analyze possible differences in the kind of exercise, according to age, sex and diagnostic subgroups. In order to evaluate the exercise 745 patients were assessed by the Eating Disorders Examination (EDE). The presence of physical activity (driving to caloric consumption, weight loss or modification of body shape), kind of activity, and its intensity were considered. Only the presence of moderate or high intensity clearly related with the mentioned objectives was considered. 407 patients (54,63 percent) engaged in exercise: 68,96 percent with anorexia, 68,96 percent with bulimia, and 34,73 percent with other non-specified eating disorders. There were not significant differences between men and women. Hyperactivity was the most frequent (47,42 percent), followed by gym activity (25,79 percent). Taking into account the different clinic subgroups, we could observe significant differences. To assess eating disorders, a correct evaluation of the physical activity should be necessary in order to include this aspect in treatment programs.

[Physical activity, eating behavior, and pathology]. / Ejercicio físico, conducta alimentaria y patología.

Intense physical activity has been reported in patients with eating disorders, and hyperactivity can be found in more than 80% in severe stages. The beginning of food restriction occurs at earlier ages if there is an intense physical activity; body dissatisfaction is more intense among patients who practice exercise; and the presence of intense activity in anorexia nervosa usually precedes to the restrictive diet. The aim of this study was to evaluate the presence of exercise at the beginning of the eating disorder, and to analyze possible differences in the kind of exercise, according to age, sex and diagnostic subgroups. In order to evaluate the exercise 745 patients were assessed by the Eating Disorders Examination (EDE). The presence of physical activity (driving to caloric consumption, weight loss or modification of body shape), kind of activity, and its intensity were considered. Only the presence of moderate or high intensity clearly related with the mentioned objectives was considered. 407 patients (54.63%) engaged in exercise: 68.96% with anorexia, 68.96% with bulimia, and 34.73% with other non-specified eating disorders. There were not significant differences between men and women. Hyperactivity was the most frequent (47.42%), followed by gym activity (25.79%). Taking into account the different clinic subgroups, we could observe significant differences. To assess eating disorders, a correct evaluation of the physical activity should be necessary in order to include this aspect in treatment programs.