ABSTRACT
Objetivo Realizar una descripción de las principales escalas utilizadas en la valoración geriátrica integral mediante un análisis narrativo detallando su aplicación clínica en relación con sus ventajas y desventajas en función de sus propiedades psicométricas (valoración mental) y los sesgos en su aplicación. Las escalas seleccionadas fueron: índice de Barthel, índice de Katz, escala de Lawton y Brody, mini-examen del estado mental, test del reloj, escala de depresión geriátrica y la escala de recursos sociales. Métodos Se realizó una revisión sistemática rápida de revisiones en MEDLINE (PubMed) hasta enero de 2021, informando de los hallazgos mediante PRISMA, 2020. Para construir la estrategia de búsqueda reproducible se empleó el lenguaje MeSH, palabras clave y los operadores booleanos AND y OR. Resultados Se seleccionaron 31 que cumplieron los criterios de elegibilidad; 18 revisiones sistemáticas, 12 revisiones de la literatura y una revisión de alcance. Se encontraron múltiples versiones para algunas de las escalas y se constataron sesgos en su interpretación. Se recomienda la administración de cuestionarios cortos y fáciles de aplicar y se aconseja que los puntos de corte se definan según la educación formal. Conclusión Las escalas de valoración geriátrica integral son instrumentos baratos, eficaces y útiles para detectar problemas y potencialidad en las personas mayores. Deben ser de fácil aplicación, no extensas, válidas para múltiples culturas y distintos niveles de educación formal y aplicables a diferentes grados de discapacidad. Es recomendable que los profesionales sanitarios se entrenen en su uso para evitar sesgos en la interpretación de los resultados (AU)
Objective This work aims to describe the main scales used in comprehensive geriatric assessment through a narrative analysis detailing their clinical application in relation to their advantages and disadvantages in terms of their psychometric properties (mental assessment) and biases in their application. The scales selected were: Barthel Index, Katz Index, Lawton and Brody Scale, Mini-Mental State Examination, Clock Test, Geriatric Depression Scale, and the Social Resources Scale. Methods We conducted a rapid systematic review of reviews in MEDLINE (PubMed) up to January 2021, reporting findings using PRISMA, 2020. MeSH language, keywords, and the Boolean operators AND and OR were used to construct the reproducible search strategy. Results Thirty-one works were selected that met the eligibility criteria: 18 systematic reviews, 12 literature reviews, and one scoping review. Multiple versions were found for some of the scales and biases in their interpretation were observed. Short, easy-to-administer questionnaires are recommended and cut-off points should be defined by formal education. Conclusion Comprehensive geriatric assessment scales are inexpensive, effective, and useful instruments for identifying problems and potential problems in the elderly. They should be easy to apply, not extensive, valid for multiple cultures and different levels of formal education, and applicable to individuals with different degrees of disability. It is recommended that health professionals be instructed in their use to avoid biases in the interpretation of the results (AU)
Subject(s)
Humans , Aged , Geriatric Assessment/methods , Psychometrics , Surveys and QuestionnairesABSTRACT
OBJECTIVE: This work aims to describe the main scales used in comprehensive geriatric assessment through a narrative analysis detailing their clinical application in relation to their advantages and disadvantages in terms of their psychometric properties (mental assessment) and biases in their application. The scales selected were: Barthel Index, Katz Index, Lawton and Brody Scale, Mini-Mental State Examination, Clock Test, Geriatric Depression Scale, and the Social Resources Scale. METHODS: We conducted a rapid systematic review of reviews in MEDLINE (PubMed) up to January 2021, reporting findings using PRISMA, 2020. MeSH language, keywords, and the Boolean operators AND and OR were used to construct the reproducible search strategy. RESULTS: Thirty-one works were selected that met the eligibility criteria: 18 systematic reviews, 12 literature reviews, and one scoping review. Multiple versions were found for some of the scales and biases in their interpretation were observed. Short, easy-to-administer questionnaires are recommended and cut-off points should be defined by formal education. CONCLUSION: Comprehensive geriatric assessment scales are inexpensive, effective, and useful instruments for identifying problems and potential problems in the elderly. They should be easy to apply, not extensive, valid for multiple cultures and different levels of formal education, and applicable to individuals with different degrees of disability. It is recommended that health professionals be instructed in their use to avoid biases in the interpretation of the results.
Subject(s)
Geriatric Assessment , Aged , Humans , Geriatric Assessment/methods , Psychometrics , Surveys and Questionnaires , Review Literature as TopicABSTRACT
El objetivo de este estudio fue valorar la prevalencia de deficiencia e insuficiencia de vitamina D en pacientes ancianos. Se realizó un estudio descriptivo, transversal en individuos mayores de 65 años que vivían en su domicilio, en una residencia de ancianos o que estaban hospitalizados. Se evaluaron 454 personas. Las concentraciones medias de 25 (OH) D3 eran 37± 20 nmol/l en individuos en domicilio, 33±17 nmol/l en pacientes en residencia y 27±14 nmol/l en pacientes hospitalizados. Se observó una relación inversa entre vitamina D y paratohormona (PTH) (r: -0,257, p = 0,0001). Las prevalencias de deficiencia e insuficiencia en vitamina D eran 79% y 31% en individuos en domicilio, 91% y 32% en pacientes en residencia y 92% y 52% en pacientes ingresados. En conclusión, podemos afirmar que la prevalencia de hipovitaminosis D en ancianos de nuestra área de salud es alta
This study aims to evaluate the prevalence of vitamin D deficiency and insufficiency in older subjects. A cross-sectional population study in subjects over 65 years of age residing in their home, in a nursing home and in-patients was performed. A total of 454 persons were evaluated. Mean serum concentrations of 25 (OH) D3 were 37± 20 nmol/l in home subjects, 33±17 nmol/l in nursing home and 27±14 nmol/l in in-patients. An inverse correlation between paratohormone (PTH) and vitamin D was found (r: -0.257, p = 0.0001). Vitamin D deficiency and insufficiency were present in 79% and 31% in home subjects, 91% and 32% in nursing home and 92% and 52% in in-patients. In conclusion, hypovitaminosis D is a very frequent finding in elderly people of the population of our health care area
