Prevalence and clinical significance of interatrial block in very older persons.

PURPOSE: The presence in older patients of an interatrial block (IAB) may be a predictor of atrial fibrillation (AF). The objective of the study was to assess in a group of very older participants: the prevalence of IAB, its association with the presence of functional and cognitive status, of new AF diagnosis and mortality after 2-year of follow-up. METHODS: A prospective subcohort of the OCTABAIX population-based study with 75 inhabitants, all 85-year-olds, at baseline in sinus rhythm were assessed. Functional and cognitive status, nutritional risk, and previous falls were recorded. Participants were classified according to the presence or absence of IAB. RESULTS: 23 patients had IAB (30.7%). We did not observe significant differences regarding gender, comorbidity, functional status, nutritional risk and global geriatric assessment according to interatrial conduction. The patients with IAB had statistically significant better cognitive performance (p = 0.029) and a lower number of previous falls (p = 0.008). During the 2 years follow-up 3 participants (4%) died; without statistical differences between both groups. A non-significant trend to a higher incidence of new-onset AF was observed in patients with IAB (8.7 vs. 6.1%; p = 0.652). CONCLUSIONS: Nearly one-third of very older patients with sinus rhythm have IAB. They had a tendency to higher incidence of AF and no association with mortality after 2 years of follow-up.

Inflammation and hemostasis in older octogenarians: implication in 5-year survival.

Social changes and medical advances have increased longevity, but the conditions governing healthy vs unhealthy cardiovascular (CV) aging are not fully known. Factors beyond classical CV risk factors may have an important unrecognized value. We sought to identify proteins differentially expressed in healthy octogenarians (HOs) without a history of cardiovascular disease (CVD) and preserved functional and cognitive state compared with octogenarians with a history of CVD and cognitive decline (UHOs) using a systems biology approach, and investigated how these proteins relate to CV mortality at 5-year follow-up. Plasmas obtained from older octogenarians (87 ± 0 years) were analyzed by 2-DE + MS and bioinformatic pathway analysis in HOs (N = 38) and UHOs with cognitive (MEC<25) and functional (Barthel<90) decline and a previous ischemic event (acute myocardial infarction and/or stroke; N = 27). Results were validated by ELISA in HOs and UHOs and in an additional group of older octogenarians without cognitive impairment but with a previous CVD manifestation (HO-CVD; N = 35). UHOs showed a coordinated change in several inflammation-related proteins (AMBP, RBP4, and ITIH4; P < 0.05), together with a significant increase in the major inducer of the acute-phase reaction, interleukin-6 (P = 0.03). UHOs also showed a coordinated increase in hemostatic proteins that was associated with an impairment of fibrinolysis and an increased 5-year CV mortality (P = 0.003). The combination of inflammation (ITIH4 and interleukin-6) and hemostatic markers (D-dimer, A2AP, and coagulation factor XIII) was able to discriminate the presence of an unhealthy phenotype in the elderly (AUC = 0.750; P = 0.001). Unhealthy older octogenarians show increased levels of several plasma proteins of inflammation and coagulation. In older octogenarians, the increase in hemostatic markers indicated an increase in 5-year CV mortality at follow-up.

Multimorbidity as specific disease combinations, an important predictor factor for mortality in octogenarians: the Octabaix study.

BACKGROUND: The population is aging and multimorbidity is becoming a common problem in the elderly. OBJECTIVE: To explore the effect of multimorbidity patterns on mortality for all causes at 3- and 5-year follow-up periods. MATERIALS AND METHODS: A prospective community-based cohort (2009-2014) embedded within a randomized clinical trial was conducted in seven primary health care centers, including 328 subjects aged 85 years at baseline. Sociodemographic variables, sensory status, cardiovascular risk factors, comorbidity, and geriatric tests were analyzed. Multimorbidity patterns were defined as combinations of two or three of 16 specific chronic conditions in the same individual. RESULTS: Of the total sample, the median and interquartile range value of conditions was 4 (3-5). The individual morbidities significantly associated with death were chronic obstructive pulmonary disease (COPD; hazard ratio [HR]: 2.47; 95% confidence interval [CI]: 1.3; 4.7), atrial fibrillation (AF; HR: 2.41; 95% CI: 1.3; 4.3), and malignancy (HR: 1.9; 95% CI: 1.0; 3.6) at 3-year follow-up; whereas dementia (HR: 2.04; 95% CI: 1.3; 3.2), malignancy (HR: 1.84; 95% CI: 1.2; 2.8), and COPD (HR: 1.77; 95% CI: 1.1; 2.8) were the most associated with mortality at 5-year follow-up, after adjusting using Barthel functional index (BI). The two multimorbidity patterns most associated with death were AF, chronic kidney disease (CKD), and visual impairment (HR: 4.19; 95% CI: 2.2; 8.2) at 3-year follow-up as well as hypertension, CKD, and malignancy (HR: 3.24; 95% CI: 1.8; 5.8) at 5 years, after adjusting using BI. CONCLUSION: Multimorbidity as specific combinations of chronic conditions showed an effect on mortality, which would be higher than the risk attributable to individual morbidities. The most important predicting pattern for mortality was the combination of AF, CKD, and visual impairment after 3 years. These findings suggest that a new approach is required to target multimorbidity in octogenarians.

Estudio Octabaix. Sumario de la valoración inicial y 5 años de seguimiento / The Octabaix study. Baseline assessment and 5 years of follow-up

Se presenta una revisión de los diversos estudios que forman parte de la valoración inicial y del seguimiento durante 5años de una cohorte de personas que cumplieron 85años en el momento de la inclusión: el estudio Octabaix. Se trata de un estudio poblacional con 328 participantes; de ellos el 61,6% eran mujeres, el 53% viudos y un tercio vivían solos. En cuanto a antecedentes, el 75,9% de pacientes presentaban hipertensión arterial, el 51,2% dislipemia y el 17,7% diabetes mellitus. Al inicio del estudio la mediana del índice de Barthel era de 95, la del Mini-Examen Cognitivo de 28, la del índice Charlson de 1, la del Mini-Nutritional Assessment de 25, la de la Escala de riesgo social de Gijón de 10, la de la escala visual analógica del test Euroqol-5D de salud percibida de 60; la media de fármacos era de 6,1. Tener una menor calidad de vida se asoció a género femenino, presentar un fenotipo de fragilidad, insuficiencia cardiaca y un elevado índice de riesgo social. A los 5años de seguimiento la tasa de mortalidad fue elevada (42,1%), lo que representaba una tasa de mortalidad del 8,4% al año. Un denominador común de los estudios incluidos en esta revisión ha sido el de la mayor importancia de la funcionalidad y comorbilidad global, como factores asociados a mortalidad en este grupo de edad muy avanzada frente a otros factores más clásicos presentes en poblaciones más jóvenes. También en este grupo de estudios se han analizado la fragilidad, las caídas, el riesgo nutricional, la diabetes y el envejecimiento satisfactorio, entre otros aspectos importantes para mejor conocer este grupo poblacional (AU)

This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group (AU)

[The Octabaix study. Baseline assessment and 5 years of follow-up]. / Estudio Octabaix. Sumario de la valoración inicial y 5 años de seguimiento.

This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group.

Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study.

OBJECTIVE: To investigate the predictive value of functional impairment, chronic conditions, and laboratory biomarkers of aging for predicting 5-year mortality in the elderly aged 85 years. METHODS: Predictive value for mortality of different geriatric assessments carried out during the OCTABAIX study was evaluated after 5 years of follow-up in 328 subjects aged 85 years. Measurements included assessment of functional status comorbidity, along with laboratory tests on vitamin D, cholesterol, CD4/CD8 ratio, hemoglobin, and serum thyrotropin. RESULTS: Overall, the mortality rate after 5 years of follow-up was 42.07%. Bivariate analysis showed that patients who survived were predominantly female (P=0.02), and they showed a significantly better baseline functional status for both basic (P<0.001) and instrumental (P<0.001) activities of daily living (Barthel and Lawton index), better cognitive performance (Spanish version of the Mini-Mental State Examination) (P<0.001), lower comorbidity conditions (Charlson) (P<0.001), lower nutritional risk (Mini Nutritional Assessment) (P<0.001), lower risk of falls (Tinetti gait scale) (P<0.001), less percentage of heart failure (P=0.03) and chronic obstructive pulmonary disease (P=0.03), and took less chronic prescription drugs (P=0.002) than nonsurvivors. Multivariate Cox regression analysis identified a decreased score in the Lawton index (hazard ratio 0.86, 95% confidence interval: 0.78-0.91) and higher comorbidity conditions (hazard ratio 1.20, 95% confidence interval: 1.08-1.33) as independent predictors of mortality at 5 years in the studied population. CONCLUSION: The ability to perform instrumental activities of daily living and the global comorbidity assessed at baseline were the predictors of death, identified in our 85-year-old community-dwelling subjects after 5 years of follow-up.

Perfil y pronóstico del paciente con anemia mayor de 85 años que vive en la comunidad. Estudio Octabaix / Profile and prognosis of patients over 85 years old with anemia living in the community. Octabaix Study

Objetivos. Analizar la prevalencia de anemia en un estudio poblacional de personas de 85 años. Explorar posibles rasgos diferenciadores en los grupos de personas con y sin anemia y evaluar la relación de la anemia con la mortalidad después de 3 años de seguimiento. Material y métodos. Estudio observacional multicéntrico de una cohorte de personas nacidas en 1924 que viven en la comunidad. Se recogieron variables sociodemográficas, de comorbilidad, funcionalidad, estado cognitivo, riesgo social, percepción de calidad de vida, estado nutricional, consumo de fármacos y parámetros analíticos. Se realizó análisis multivariable con regresión logística. Resultados. Se incluyeron 328 habitantes, 61,6% mujeres. La prevalencia de anemia fue del 24%. Se apreciaron diferencias estadísticamente significativas en cuanto al índice de Charlson, con valores más altos en pacientes anémicos (p = 0,0001) y al índice de Barthel (IB) y al índice de Lawton (IL), con valores menores en anémicos (p = 0,002 para ambos). Los pacientes con anemia tenían peor percepción de su calidad de vida (p = 0,015). En el análisis multivariable la presencia de anemia se relacionaba con más dependencia según el IB (OR 0,985; IC 95%: 0,973-0,997) y más comorbilidad según el índice de Charlson (OR 1,314; IC 95%: 1,124-1,536). La mortalidad fue mayor en el grupo de pacientes con anemia a los 3 años (p = 0,005). Conclusiones. En nuestra cohorte la anemia es prevalente en población de 85 años y se asocia con mayor mortalidad a los 3 años. Los pacientes anémicos presentaban peor funcionalidad física y mayor comorbilidad (AU)

Objectives. To analyze the prevalence of anemia in a sample of patients over 85 years old. To explore possible differentiating features in the groups of people with and without anemia, and to evaluate the relationship of anemia with mortality after a follow-up of 3 years. Material and methods. An observational multicenter study was conducted on a cohort of people born in 1924 and who lived in the community. Socio-demographic variables, comorbidity, functionality, cognitive status, social risk, perceived quality of life, nutritional status, drug consumption and laboratory parameters were collected. Multivariate logistic regression analysis was performed. Results. A total of 328 inhabitants were included, of whom 61.6% were women. The prevalence of anemia was 24%. Statistically significant differences in the Charlson index were found, showing higher values in anemic patients (P = 0001) and in the Barthel index (BI) and in the Lawton index (LI), with lower levels in anemic patients (P = 002 for both). Patients with anemia had a poorer perception of their quality of life (P = 015). The presence of anemia was associated with more dependence according the BI values (OR 0.985; 95% CI: 0973-0997) and with higher comorbidity according the Charlson index (OR 1.314; 95% CI: 1124-1536). Mortality was higher in the group of patients with anemia, reaching statistically significant differences in the third year P = 005). Conclusions. In our cohort anemia is a fairly prevalent feature in the population over 85 years old, and is associated with higher mortality at three years of follow up. Patients with anemia had worse physical functioning and greater comorbidity (AU)

Diabetes mellitus a los 85 años en la comunidad. Estudio Octabaix / Diabetes mellitus at 85 years in the community. Octabaix study

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[Profile and prognosis of patients over 85 years old with anemia living in the community. Octabaix Study]. / Perfil y pronóstico del paciente con anemia mayor de 85 años que vive en la comunidad. Estudio Octabaix.

OBJECTIVES: To analyze the prevalence of anemia in a sample of patients over 85 years old. To explore possible differentiating features in the groups of people with and without anemia, and to evaluate the relationship of anemia with mortality after a follow-up of 3 years. MATERIAL AND METHODS: An observational multicenter study was conducted on a cohort of people born in 1924 and who lived in the community. Socio-demographic variables, comorbidity, functionality, cognitive status, social risk, perceived quality of life, nutritional status, drug consumption and laboratory parameters were collected. Multivariate logistic regression analysis was performed. RESULTS: A total of 328 inhabitants were included, of whom 61.6% were women. The prevalence of anemia was 24%. Statistically significant differences in the Charlson index were found, showing higher values in anemic patients (P=0001) and in the Barthel index (BI) and in the Lawton index (LI), with lower levels in anemic patients (P=002 for both). Patients with anemia had a poorer perception of their quality of life (P=015). The presence of anemia was associated with more dependence according the BI values (OR 0.985; 95% CI: 0973-0997) and with higher comorbidity according the Charlson index (OR 1.314; 95% CI: 1124-1536). Mortality was higher in the group of patients with anemia, reaching statistically significant differences in the third year P=005). CONCLUSIONS: In our cohort anemia is a fairly prevalent feature in the population over 85 years old, and is associated with higher mortality at three years of follow up. Patients with anemia had worse physical functioning and greater comorbidity.

Diabetes mellitus as a risk factor for functional and cognitive decline in very old people: the Octabaix study.

OBJECTIVES: To examine the incidence of functional or cognitive impairment and its associated factors in a sample of individuals aged 85 years or older with and without diabetes mellitus, who were free of significant impairment at baseline. DESIGN: Longitudinal study. SETTING: Community-based survey study of 7 primary health care centers. PARTICIPANTS: A total of 167 individuals born in 1924 who completed 2 years of follow-up. MEASUREMENTS: Sociodemographic variables, the Barthel Index (BI), the Spanish version of Mini-Mental State Examination (MEC), the Mini Nutritional Assessment (MNA), the Charlson Comorbidity Index, and a list of chronic drug prescriptions. A comparative analysis was performed between diabetic and nondiabetic patients regarding the rate of functional and cognitive impairment. In addition, in older people with diabetes experiencing incident disability, an analysis of the potential factors involved was carried out. RESULTS: The prevalence of diabetes (DM) at baseline in this population was 25.1%. After 2 years of follow-up, 66.8% of patients with DM had developed a new impairment measured as 38.1% for the defined target of loss of BI of 10 or more and 33.3% for the cognitive target (MEC scores lower than 24 or loss >4 points in MEC). In a multivariate analysis, diabetic patients had an increased risk of any new disability (OR 2.05, 95% CI 1.01-4.36; P = .04). Logistic regression showed an association between any new disability and baseline scores of MNA (OR 1.35, 95% CI 1.01-1.82; P = .04) and MEC (OR 1.38, 95% CI 1.02-1.85; P = .003). CONCLUSION: This study has identified that in the oldest old, community-dwelling individuals without evidence of severe functional impairment at baseline, diabetes increases the risk of incident disability in only 2 years.

Thyroid status and functional and cognitive status at baseline and survival after 3 years of follow-up: the OCTABAIX study.

OBJECTIVE: Subclinical thyroid disorders are common in older individuals. Health risks associated with subclinical hypothyroidism in older adults are unclear. The aim of the study is to evaluate whether thyroid status in elderly subjects correlates with physical and cognitive function at baseline and with 3-year mortality. DESIGN: A population-based, prospective cohort of the OCTABAIX study (307 inhabitants aged 85 years at baseline). METHODS: Chronic drug prescription, functional status (Barthel and Lawton indices) and cognitive status according to the Spanish version of the Mini-Mental State Examination were recorded. Quality of life was assessed using the visual analogue scale of the quality of life test. Concentrations of TSH and thyroxine were measured. Participants were classified in accordance with clinical categories of thyroid function. RESULTS: Twenty (6.5%) individuals had subclinical hypothyroidism and five (1.6%) had subclinical hyperthyroidism. Compared with euthyroid subjects (n=280; 91.8%), subclinical hypo- and hyperthyroidism subjects were not significantly associated with poor physical or cognitive function at baseline. Fifty-one (15.1%) subjects died during the 36 months of follow-up. TSH values and subclinical hypo- and hyperthyroidism were not associated with an increased overall mortality risk (hazard ratio (HR) 1.086, 95% CI 0.987-1.196 and HR 0.905, 95% CI 0.902-1.053 respectively). CONCLUSIONS: This study does not support the association of TSH or thyroid disorders with physical or cognitive function at baseline or with 3-year mortality in the oldest old subjects.

Geriatric assessment and chronic kidney disease in the oldest old: the Octabaix study.

BACKGROUND: The prevalence of chronic kidney disease (CKD) in older people is increasing. We determine the proportion of CKD in a sample of 321, 85-year-old community-dwelling subjects, and assess the association of socio-demographic data, global geriatric assessment data and comorbidity with CKD according to the estimated glomerular filtration rate (eGFR) of subjects. METHODS: Serum creatinine, eGFR (derived in ml/min/1.73 m(2) using the Modification of Diet in Renal Disease formula), socio-demographic variables, the Barthel Index (BI), the Spanish version of the Mini-Mental State Examination (MEC), the Mini Nutritional Assessment (MNA), the Charlson Index, the Gait Rating Scale, social risk, quality of life and prevalent chronic diseases were collected. RESULTS: CKD prevalence was 56.7% for eGFR < 60 ml/min/1.73 m(2), 19.9% for eGFR < 45 ml/min/1.73 m(2) and 6.6% for GFR < 30 ml/min/1.73 m(2). Multiple logistic regression analysis showed that a prior diagnosis of hypertension was associated with an eGFR < 60 ml/min/1.73 m(2) (p<0.008, OR 2.134, 95% CI 1.216-3.744). A diagnosis of heart failure (p<0.001, OR 3.610, 95% CI 1.677-7.771) and a poor score on the quality of life measure (p<0.008, OR 0.9660, 95% CI 0.966-0.995) were associated with an eGFR < 45 ml/min/1.73 m(2). CONCLUSIONS: More than half of the oldest old in this study had an eGFR < 60 ml/min/1.73 m(2). A history of hypertension was associated with CKD. The group of patients with an eGFR < 45 ml/min/1.73 m(2) was associated with a diagnosis of heart failure and a worse quality of life.

Diabetes mellitus: prevalence and effect of morbidities in the oldest old. The Octabaix study.

OBJECTIVES: To describe the prevalence of diabetes mellitus (DM) in community-dwelling 85-year-olds and to study the factors associated. DESIGN: Cross-sectional. SETTING: Community-based survey study of seven primary healthcare centers. PARTICIPANTS: Three hundred twenty-eight people born in 1924 and registered with primary healthcare centers. MEASUREMENTS: Information on sociodemographic variables, Barthel Index (BI), Spanish version of the Mini-Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Braden scale for risk of pressure ulcers, Charlson Comorbidity Index, chronic diseases, social risk, quality of life, chronic drug prescriptions, and blood tests was recorded. Participants were defined as having DM according to self-report, physician diagnosis, antidiabetic prescriptions, or plasma glucose concentration 7 mmol/L or more. A comparative analysis was performed between participants with and without DM. RESULTS: The prevalence of DM in 328 octogenarians studied was 25.9%. Logistic regression showed an association between DM and BI (odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.00-1.05, P = .007), Braden risk score (OR = 0.87, 95% CI = 0.79-0.97, P = .01), thyroid disease (OR = 0.23, 95% CI = 0.06-0.92, P = .04), chronic drug prescriptions (OR = 1.28, 95% CI = 1.15-1.42, P < .001), white-cell count (OR = 1.34, 95% CI = 1.15-1.56, P < .001), low-density lipoprotein cholesterol (LDL-C; OR = 0.63, 95% CI = 0.43-0.92, P = .02) and folic acid level (OR = 1.04, 95% CI = 1.01-1.07, P = .005). CONCLUSION: There is a high prevalence of DM at 85 years old. The presence of DM was positively associated with disability, drug prescription, white blood cell count, and folic acid level, whereas there was an inverse relationship between DM and Braden scale score, thyroid disease, and LDL-C. The effect of morbidities on DM may require a multidisciplinary approach to manage its complexity.

Differences according to gender and health status in CD4:CD8 ratio in a sample of community-dwelling oldest old. The OCTABAIX immune study.

BACKGROUND AND AIMS: The presence of an immune-risk phenotype (IRP) has been correlated with survival rates in elderly people. The aim of this study is to characterize the inverted CD4:CD8 ratio as a possible marker of IRP in a sample of oldest old (85 years) by assessing differences in gender and health status. METHODS: Comorbidity, functional status (Barthel Index), and cognitive status with the Spanish version of the Mini-Mental State Examination were evaluated. Non-disabled subjects were defined as those with better health status, with scores of >90 on the Barthel Index and >23 points on the Spanish version of the Mini-Mental State Examination. CD4:CD8 ratios were recorded, and a ratio of 1.00 or less was used to define IRF. RESULTS: Three hundred and twelve subjects aged 85 years old were studied, 190 women (60.9%) and 122 men. The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%) and higher than 2.2 in 115 (36.8%). There were no differences in CD4:CD8 ratio according to health status. The inverted CD4:CD8 ratio was more frequent in men (55.3%). CONCLUSION: In this community-dwelling, single year birth cohort study, the subgroup with poor health status did not have a lower CD4:CD8 ratio. The inverted CD4:CD8 ratio was more frequent in men.

Ensayo clínico aleatorizado de prevención de caídas y malnutrición en personas de 85 años en la comunidad. Estudio OCTABAIX / A randomized clinical trial of falls and malnutrition prevention in community-dwelling elders aged 85 years old. The OCTABAIX study

IntroducciónEl incremento en la pirámide poblacional conlleva un aumento del grupo de personas mayores de 85 años. En este grupo poblacional es frecuente la presencia de síndromes geriátricos como las caídas y la malnutrición.ObjetivoEvaluar la efectividad de una intervención individualizada multifactorial para conseguir disminuir las caídas y la malnutrición en personas de 85 años de la comunidad.Material y métodosSe trata de un ensayo clínico aleatorizado a 3 años, realizado en el ámbito de Atención Primaria de Costa de Ponent (7 equipos). Se han incluido los residentes en la comunidad nacidos en el año 1924, no institucionalizados y que aceptaron participar en el estudio. Se realizarán 3 entrevistas anuales presenciales por investigadores entrenados, complementadas con 2 estudios analíticos de periodicidad bianual. Recibieron calendarios mensuales donde registraron caídas y peso, además de las hospitalizaciones. De manera aleatoria, se realizó a un grupo una intervención multidisciplinar individualizada específica, según algoritmo diseñado para factores de riesgo de caídas y/o malnutrición. Se realizaron 2 intervenciones presenciales y llamadas telefónicas de adhesión. El grupo control seguirá las recomendaciones habituales en Atención Primaria. La variable principal del estudio fue conseguir disminuir incidencias de caídas y malnutrición.ResultadosEl estudio OCTABAIX espera disminuir los índices de caídas, y de malnutrición en el grupo de 328 pacientes incluidos.ConclusionesEl estudio OCTABAIX nos ayudará a conocer las características de las personas de 85 años, además de la proporción de caídas y de riesgo nutricional y la efectividad de las medidas implementadas para disminuir dichos síndromes geriátricos(AU)

IntroductionPeople aged 85 years old and older constitute a growing population group. Falls and malnutrition are common in the elderly.ObjectiveTo determine the effectiveness of an individualized multifactorial intervention to reduce falls and malnutrition in community-dwelling persons aged 85 years old.Material and methodsThe OCTABAIX study is a randomized controlled clinical trial lasting 3 years in primary care in Costa de Ponent (seven primary care teams). Community-dwelling elders born in 1924 who agreed to participate in the study have been included. Three in-home visits will be made annually by a trained nurse or physician and will be complemented by two biannual analytical studies. Participants will be followed-up for hospitalizations, falls and weight using a monthly calendar. The specifically-designed algorithm to detect risk factors for falls and malnutrition will be used to provide recommendations and specific, standardized interventions for risk reduction in a randomly selected intervention group. Two face-to-face interventions will be carried out and telephone calls will be made to reinforce adherence. The control group will follow routine primary care recommendations. The primary outcome is a decline in the rate of falls and malnutrition.ResultsThe OCTABAIX study aims to reduce the incidence of falls and the risk of malnutrition in the 328 patients included.ConclusionsThe OCTABAIX study will help to determine the characteristics of persons aged 85 years old as well as the rate of falls and nutritional risk. The effectiveness of the measures adopted to reduce these geriatric syndromes will also be assessed(AU)

[A randomized clinical trial of falls and malnutrition prevention in community-dwelling elders aged 85 years old. The OCTABAIX study]. / Ensayo clínico aleatorizado de prevención de caídas y malnutrición en personas de 85 años en la comunidad. Estudio OCTABAIX.

INTRODUCTION: People aged 85 years old and older constitute a growing population group. Falls and malnutrition are common in the elderly. OBJECTIVE: To determine the effectiveness of an individualized multifactorial intervention to reduce falls and malnutrition in community-dwelling persons aged 85 years old. MATERIAL AND METHODS: The OCTABAIX study is a randomized controlled clinical trial lasting 3 years in primary care in Costa de Ponent (seven primary care teams). Community-dwelling elders born in 1924 who agreed to participate in the study have been included. Three in-home visits will be made annually by a trained nurse or physician and will be complemented by two biannual analytical studies. Participants will be followed-up for hospitalizations, falls and weight using a monthly calendar. The specifically-designed algorithm to detect risk factors for falls and malnutrition will be used to provide recommendations and specific, standardized interventions for risk reduction in a randomly selected intervention group. Two face-to-face interventions will be carried out and telephone calls will be made to reinforce adherence. The control group will follow routine primary care recommendations. The primary outcome is a decline in the rate of falls and malnutrition. RESULTS: The OCTABAIX study aims to reduce the incidence of falls and the risk of malnutrition in the 328 patients included. CONCLUSIONS: The OCTABAIX study will help to determine the characteristics of persons aged 85 years old as well as the rate of falls and nutritional risk. The effectiveness of the measures adopted to reduce these geriatric syndromes will also be assessed.