[Cognitive deterioration following cerebral infarction: frequency and determining factors]. / Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes.

INTRODUCTION: Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factors associated to CD after a stroke vary from one study to another. AIMS: To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence. PATIENTS AND METHODS: A descriptive study was performed involving 126 stroke survivors who were hospitalised for rehabilitation. Patients were classified as having CD if they had scores below the cut-off point in one of the cognitive tests that were applied, i.e. the Folstein Minimental Test (< 24) or the Command-Condition Clock Test (< 7). The explanatory variables were: demographic variables (age, sex and years of schooling), comorbidity (arterial hypertension, diabetes mellitus and intelligence quotient), noxious habits (smoking and drinking), variables related to the lesion (extension, hemisphere and location), and others related to the consequences of the stroke (neurological status and depression). Bivariate and logistic regression analyses were performed to determine the role of these variables in CD. RESULTS: CD was observed in 51.6% of the patients. In the bivariate analysis, the extension of the infarction, age, years of schooling, degree of neurological compromise and depression were associated with the presence of CD. The logistic regression model showed that the factors explaining CD were severe neurological compromise (OR = 22.9; CI 95% = 4.2-125.2), having major depression (OR = 2.9; CI 95% = 1.14-7.8) and older age (OR = 0.94; CI 95% = 0.89-0.98). CONCLUSIONS: A little more than half of all stroke survivors, who are undergoing rehabilitation in hospital, have CD. The factors with the greatest explanatory power to account for CI were neurological status, depression and age.

Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes / Cognitive deterioration following cerebral infarction: frequency and determining factors

El ictus se asocia con frecuencia a deterioro cognitivo (DC) de diverso grado; los factores de riesgoasociados al DC después de un ictus varían entre estudios. Objetivos. Determinar la frecuencia de DC después de un infarto cerebral e identificar los factores que explican su presencia. Pacientes y métodos. Estudio descriptivo de 126 supervivientes aun ictus, hospitalizados para rehabilitación. Se clasificaron como DC aquéllos con puntuaciones por debajo del punto de corte en una de las pruebas cognitivas aplicadas: test minimental de Folstein (< 24) o prueba del reloj a la orden (< 7). Comovariables explicativas: variables demográficas (edad, sexo y años de estudio cursados), sobre comorbilidad (hipertensión arterial, diabetes mellitus y cardiopatía isquémica), hábitos tóxicos (tabaquismo y alcohol), relacionadas con la lesión (extensión,hemisferio y localización) y relacionadas con las consecuencias del ictus (estado neurológico y depresión). Se realizó un análisis bivariado y de regresión logística para determinar el papel de estas variables en el DC. Resultados. El 51,6% de lospacientes presentó DC. En el análisis bivariado, la extensión del infarto, la edad, los años de estudio, el grado de afectación neurológica y la depresión se asociaron a la presencia de DC. El modelo de regresión logística mostró que los factores que explicanel DC fueron: una afectación neurológica grave (OR = 22,9; IC 95%: = 4,2-125,2), tener una depresión mayor (OR = 2,9; IC 95% = 1,14-7,8) y una mayor edad (OR = 0,94; IC 95% = 0,89-0,98). Conclusiones. Poco más de la mitad de los supervivientes a un ictus que se hospitalizan para rehabilitación presentan DC. Los factores que explican con mayor fuerza el DC fueron el estado neurológico, la depresión y la edad

Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factorsassociated to CD after a stroke vary from one study to another. Aims. To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence. Patients and methods. A descriptive study was performedinvolving 126 stroke survivors who were hospitalised for rehabilitation. Patients were classified as having CD if they had scores below the cut-off point in one of the cognitive tests that were applied, i.e. the Folstein Minimental Test (< 24) or the Command-Condition Clock Test (< 7). The explanatory variables were: demographic variables (age, sex and years ofschooling), comorbidity (arterial hypertension, diabetes mellitus and intelligence quotient), noxious habits (smoking and drinking), variables related to the lesion (extension, hemisphere and location), and others related to the consequences of the stroke (neurological status and depression). Bivariate and logistic regression analyses were performed to determine the role ofthese variables in CD. Results. CD was observed in 51.6% of the patients. In the bivariate analysis, the extension of the infarction, age, years of schooling, degree of neurological compromise and depression were associated with the presence ofCD. The logistic regression model showed that the factors explaining CD were severe neurological compromise (OR = 22.9; CI 95% = 4.2-125.2), having major depression (OR = 2.9; CI 95% = 1.14-7.8) and older age (OR = 0.94; CI 95% = 0.89- 0.98). Conclusions. A little more than half of all stroke survivors, who are undergoing rehabilitation in hospital, have CD. Thefactors with the greatest explanatory power to account for CI were neurological status, depression and age

[Validation of the stroke-specific quality of life scale (ECVI-38)]. / Validación de la escala de calidad de vida para el ictus (ECVI-38).

INTRODUCTION: The stroke-specific quality of life scale (ECVI-38) is the first Spanish-language instrument for evaluating the quality of life in individuals who have survived a stroke. AIM: To evaluate the psychometric properties of the third version of the ECVI-38. PATIENTS AND METHODS: A total of 243 stroke survivors were interviewed 2 months-2 years after the event; 61 of them were surveyed again 7-14 days later and 74 others were interviewed on beginning and ending a two-month period of rehabilitation. Gold standard methods for this type of research were used to evaluate the psychometric properties (acceptability, reliability, validity and sensitivity to change). RESULTS. The ECVI was acceptable, with means close to the medians, a high degree of variability of the sample and a ceiling/floor effect below 20%, except for the odd exception. It displayed good reliability with internal consistence, with a Cronbach's alpha value of between 0.79 and 0.95, and a test-retest with intraclass correlation coefficients between 0.81 and 0.96. It satisfied the validity criteria both in analyses within the scale and in analyses against external criteria: it distinguishes well between different degrees of neurological, emotional and cognitive compromise. Sensitivity to change, at eight weeks after rehabilitation, was between moderate and high in most domains: there were significant differences between the scores for the domains, and the size of the effect was above 0.5. CONCLUSIONS: The ECVI-38 is acceptable, valid and reliable for evaluating the spectrum of consequences and recovery from a stroke, and its result changes in proportion to recovery.

Validación de la escala de calidad de vida para el ictus (ECVI-38) / Validation of the stroke-specific quality of life scale (ECVI-38)

La escala de calidad de vida para el ictus (ECVI-38) es el primer instrumento desarrollado en hablahispana para valorar la calidad de vida en los supervivientes a un accidente cerebrovascular. Objetivo. Evaluar las propiedades psicométricas de la tercera versión de la ECVI-38. Pacientes y métodos. Se entrevistó a 243 supervivientes a un ictus despuésde 2 meses a 2 años del evento; 61 de éstos volvieron a ser encuestados 7-14 días después, y otros 74 fueron entrevistados al ingreso y al alta tras dos meses de rehabilitación. Para evaluar las propiedades psicométricas (aceptabilidad, fiabilidad,validez y sensibilidad al cambio), se emplaron métodos de referencia para este tipo de trabajos. Resultados. La ECVI fue aceptable: medias cercanas a las medianas, gran variabilidad de la muestra y efecto suelo-techo inferior a 20%, salvo excepciones.Mostró buena fiabilidad: consistencia interna con coeficiente alfa de Cronbach entre 0,79 y 0,95, y prueba test-retest con coeficientes de correlación intraclase entre 0,81 y 0,96. Cumplió los criterios para la validez, tanto en análisis dentro dela escala como en análisis contra criterio externo: diferencia bien entre distintos grados de afectación neurológica, emocional y cognitiva. La sensibilidad al cambio, después de ocho semanas de rehabilitación, fue entre moderada y alta en la mayoríade los dominios: diferencias significativas entre las puntuaciones de los dominios y tamaño del efecto por encima de 0,5. Conclusión. La ECVI-38 es aceptable, válida y fiable para valorar el espectro de consecuencias y la recuperación de un ictus,y su resultado cambia proporcionalmente a la recuperación

The stroke-specific quality of life scale (ECVI-38) is the first Spanish-language instrument forevaluating the quality of life in individuals who have survived a stroke. Aim. To evaluate the psychometric properties of the third version of the ECVI-38. Patients and methods. A total of 243 stroke survivors were interviewed 2 months-2 years after the event; 61 of them were surveyed again 7-14 days later and 74 others were interviewed on beginning and ending a twomonthperiod of rehabilitation. Gold standard methods for this type of research were used to evaluate the psychometricproperties (acceptability, reliability, validity and sensitivity to change). Results. The ECVI was acceptable, with means close to the medians, a high degree of variability of the sample and a ceiling/floor effect below 20%, except for the odd exception. It displayed good reliability with internal consistence, with a Cronbach’s alpha value of between 0.79 and 0.95, and a test-retest with intraclass correlation coefficients between 0.81 and 0.96. It satisfied the validity criteria both in analyses within the scale and in analyses against external criteria: it distinguishes well between different degrees of neurological, emotional and cognitive compromise. Sensitivity to change, at eight weeks after rehabilitation, was between moderate and high in most domains: there were significant differences between the scores for the domains, and the size of the effect was above 0.5. Conclusions. The ECVI-38 is acceptable, valid and reliable for evaluating the spectrum of consequences and recovery from a stroke, and its result changes in proportion to recovery

Validación de la escala de calidadde vida para el ictus (ECVI-38) / Validation of the stroke-specific quality of life scale (ECVI-38)

Introducción. La escala de calidad de vida para el ictus (ECVI-38) es el primer instrumento desarrollado en habla hispana para valorar la calidad de vida en los supervivientes a un accidente cerebrovascular. Objetivo. Evaluar las propiedades psicométricas de la tercera versión de la ECVI-38. Pacientes y métodos. Se entrevistó a 243 supervivientes a un ictus despuésde 2 meses a 2 años del evento; 61 de éstos volvieron a ser encuestados 7-14 días después, y otros 74 fueron entrevistados al ingreso y al alta tras dos meses de rehabilitación. Para evaluar las propiedades psicométricas (aceptabilidad, fiabilidad,validez y sensibilidad al cambio), se emplaron métodos de referencia para este tipo de trabajos. Resultados. La ECVI fue aceptable: medias cercanas a las medianas, gran variabilidad de la muestra y efecto suelo-techo inferior a 20 por ciento, salvo excepciones. Mostró buena fiabilidad: consistencia interna con coeficiente alfa de Cronbach entre 0,79 y 0,95, y prueba test-retest con coeficientes de correlación intraclase entre 0,81 y 0,96. Cumplió los criterios para la validez, tanto en análisis dentro de la escala como en análisis contra criterio externo: diferencia bien entre distintos grados de afectación neurológica, emocional y cognitiva. La sensibilidad al cambio, después de ocho semanas de rehabilitación, fue entre moderada y alta en la mayoríade los dominios: diferencias significativas entre las puntuaciones de los dominios y tamaño del efecto por encima de 0,5. Conclusión. La ECVI-38 es aceptable, válida y fiable para valorar el espectro de consecuencias y la recuperación de un ictus, y su resultado cambia proporcionalmente a la recuperación(AU)

Introduction. The stroke-specific quality of life scale (ECVI-38) is the first Spanish-language instrument forevaluating the quality of life in individuals who have survived a stroke. Aim. To evaluate the psychometric properties of the third version of the ECVI-38. Patients and methods. A total of 243 stroke survivors were interviewed 2 months-2 years afterthe event; 61 of them were surveyed again 7-14 days later and 74 others were interviewed on beginning and ending a twomonth period of rehabilitation. Gold standard methods for this type of research were used to evaluate the psychometric properties (acceptability, reliability, validity and sensitivity to change). Results. The ECVI was acceptable, with means closeto the medians, a high degree of variability of the sample and a ceiling/floor effect below 20 percent, except for the odd exception. It displayed good reliability with internal consistence, with a Cronbachs alpha value of between 0.79 and 0.95, and a test-retest with intraclass correlation coefficients between 0.81 and 0.96. It satisfied the validity criteria both in analyses within the scale and in analyses against external criteria: it distinguishes well between different degrees of neurological, emotional andcognitive compromise. Sensitivity to change, at eight weeks after rehabilitation, was between moderate and high in most domains: there were significant differences between the scores for the domains, and the size of the effect was above 0.5. Conclusions. The ECVI-38 is acceptable, valid and reliable for evaluating the spectrum of consequences and recovery from astroke, and its result changes in proportion to recovery(AU)

Escala de calidad de vida para el ictus (ECVI-38): evaluación de su aceptabilidad, fiabilidad y validez / Stroke-specific quality of life scale (ecvi-38): an evaluation of its acceptance, reliability and validity

Introducción y objetivos. La calidad de vida relacionada con la salud (CVRS) actualmente es clave en la evaluación de ensayos clínicos para el ictus. Las escalas ictus específicas existentes se desarrollaron en países anglosajones y la mayoría no reúnen los requisitos de validez necesarios. Por ello, se desarrolló la primera escala hispana para evaluar calidad de vida (CV) en sobrevivientes a un ictus (ECVI-38). En este trabajo se evaluaron las propiedades psicométricas de esta medida resumen. Pacientes y métodos. Se estudiaron 63 pacientes con ictus, entre 2 meses y 2años de su ocurrencia, para evaluar la aceptabilidad, fiabilidad yla validez de la ECVI-38, con la utilización de métodos psicométricos estandarizados. Resultados. La ECVI-38 demostró buena aceptabilidad; solamente tres elementos tuvieron alto porcentaje de datos perdidos debido a la edad de los pacientes de la muestra; los efectos piso y techo estuvieron dentro de los límites aceptados. La escala mostró buena consistencia interna ( α de Cronbach0,79-0,97, correlaciones interelemento 0,53-0,90) y buena estabilidad en la prueba test-retest (coeficientes de correlación intraclase0,89-0,98). En cuanto a su validez de construcción (correlacion estotales entre dominios correctas, r = 0,57-0,90 convergente ,r = 0,19-0,39 discriminante), sus resultados fueron muy buenos; así como los estudios de validez contra criterio externo (diferencia entre grupos con estado neurológico conocido, y validez de convergencia). Conclusiones. La ECVI-38 es una medida aceptable, fiable y válida para la evaluación de la CV en pacientes que sufrieron un ictus. Se necesitan nuevas pruebas para evaluar su sensibilidad e investigar su utilidad en la práctica clínica e investigadora (AU)

Introduction and aims. Health-related quality of life (HRQL) is currently essential in the evaluation of stroke-related clinical trials. Existing stroke-specific scales were developed in English-speaking countries and most of them do not satisfy the necessary standards of validity. In consequence, the first Spanish-language scale for evaluating the quality of life (QL) of stroke survivors was developed (ECVI-38). In this work the psychometric properties of this summary measure were assessed. Patients and methods. A group of 63 stroke patients were studied, between 2 months and 2 years after the event, to evaluate the acceptability, reliability and validity of the ECVI-38, using standardised psychometric methods. Results. The ECVI-38 proved to have an important degree of acceptability; only three elements showed a high percentage of data loss due to the age of the patients in the sample; the floor and ceiling effects were within the accepted limits. The scale displayed good internal consistency (Cronbach’s α 0.79-0.97, correlations between elements 0.53-0.90) and good stability in the test-retest trial (intraclass correlation coefficients 0.89-0.98). As regards its construct validity (total correlations among correct domains, convergent r = 0.57-0.90, discriminating r = 0.19-0.39), the results were very good, as were the findings of the studies of validity vs. external criteria (difference between groups with a known neurological status, and convergence validity). Conclusions. The ECVI-38 is a measure that is acceptable, reliable and valid for evaluating QL in patients who have had a stroke. Further tests are needed to evaluate its sensitivity and to explore its value in both clinical and research practice (AU)

Escala de calidad de vida para el ictus (ECVI-38): evaluación de su aceptabilidad, fiabilidad y validez / Stroke-specific quality of life scale (ECVI-38): an evaluation of its acceptance, reliability and validity

Health-related quality of life (HRQL) is currently essential in the evaluation of stroke-related clinical trials. Existing stroke-specific scales were developed in English-speaking countries and most of them do not satisfy the necessary standards of validity. In consequence, the first Spanish-language scale for evaluating the quality of life (QL) of stroke survivors was developed (ECVI-38). In this work the psychometric properties of this summary measure were assessed. A group of 63 stroke patients were studied, between 2 months and 2 years after the event, to evaluate the acceptability, reliability and validity of the ECVI-38, using standardised psychometric methods. The ECVI-38 proved to have an important degree of acceptability; only three elements showed a high percentage of data loss due to the age of the patients in the sample; the floor and ceiling effects were within the accepted limits. The scale displayed good internalconsistency (Cronbachs á 0.79-0.97, correlations between elements 0.53-0.90) and good stability in the test-retest trial (intraclass correlation coefficients 0.89-0.98). As regards its construct validity (total correlations among correct domains, convergentr = 0.57-0.90, discriminating r = 0.19-0.39), the results were very good, as were the findings of the studies of validity vs. external criteria (difference between groups with a known neurological status, and convergence validity). The ECVI-38 isa measure that is acceptable, reliable and valid for evaluating QL in patients who have had a stroke. Further tests are needed to evaluate its sensitivity and to explore its value in both clinical and research practice. [REV NEUROL 2005; 41: 391-8] Key words. Psychometric properties. Quality of life scale. Stroke. Summary measure(AU)

La calidad de vida relacionada con la salud (CVRS) actualmente es clave en la evaluación de ensayos clínicos para el ictus. Las escalas ictusespecíficas existentes se desarrollaron en países anglosajones y la mayoría no reúnen los requisitos de validez necesarios. Por ello, se desarrolló la primera escala hispana para evaluar calidad de vida (CV) en sobrevivientes a un ictus (ECVI-38). En este trabajo se evaluaron las propiedades psicométricas de esta medida resumen. Se estudiaron 63 pacientes con ictus, entre 2 meses y 2 años de su ocurrencia, para evaluar la aceptabilidad, fiabilidad y la validez de la ECVI-38, con la utilización de métodos psicométricos estandarizados. La ECVI-38 demostró buena aceptabilidad; solamente tres elementos tuvieron alto porcentaje de datos perdidos debido a la edad de los pacientes de la muestra; los efectos piso y techo estuvieron dentro de los límites aceptados. La escala mostró buena consistencia interna (a de Cronbach 0,79-0,97, correlaciones interelemento 0,53-0,90) y buena estabilidad en la prueba test-retest (coeficientes de correlación intraclase 0,89-0,98). En cuanto a su validez de construcción (correlaciones totales entre dominios correctas, r = 0,57-0,90 convergente, r = 0,19-0,39 discriminante), sus resultados fueron muy buenos; así como los estudios de validez contra criterio externo (diferencia entre grupos con estado neurológico conocido, y validez de convergencia). La ECVI-38 es una medida aceptable, fiable y válida para la evaluación de la CV en pacientes que sufrieron un ictus. Se necesitan nuevas pruebas para evaluar su sensibilidad e investigar su utilidad en la práctica clínica e investigadora(AU)

[Stroke-specific quality of life scale (ECVI-38): an evaluation of its acceptance, reliability and validity]. / Escala de calidad de vida para el ictus (ECVI-38): evaluación de su aceptabilidad, fiabilidad y validez.

INTRODUCTION AND AIMS: Health-related quality of life (HRQL) is currently essential in the evaluation of stroke-related clinical trials. Existing stroke-specific scales were developed in English-speaking countries and most of them do not satisfy the necessary standards of validity. In consequence, the first Spanish-language scale for evaluating the quality of life (QL) of stroke survivors was developed (ECVI-38). In this work the psychometric properties of this summary measure were assessed. PATIENTS AND METHODS: A group of 63 stroke patients were studied, between 2 months and 2 years after the event, to evaluate the acceptability, reliability and validity of the ECVI-38, using standardised psychometric methods. RESULTS: The ECVI-38 proved to have an important degree of acceptability; only three elements showed a high percentage of data loss due to the age of the patients in the sample; the floor and ceiling effects were within the accepted limits. The scale displayed good internal consistency (Cronbach's alpha 0.79-0.97, correlations between elements 0.53-0.90) and good stability in the test-retest trial (intraclass correlation coefficients 0.89-0.98). As regards its construct validity (total correlations among correct domains, convergent r = 0.57-0.90, discriminating r = 0.19-0.39), the results were very good, as were the findings of the studies of validity vs. external criteria (difference between groups with a known neurological status, and convergence validity). CONCLUSIONS: The ECVI-38 is a measure that is acceptable, reliable and valid for evaluating QL in patients who have had a stroke. Further tests are needed to evaluate its sensitivity and to explore its value in both clinical and research practice.

[The development of a scale to evaluate the quality of life in stroke survivors]. / Desarrollo de una escala para evaluar la calidad de vida en supervivientes a un ictus.

INTRODUCTION: The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. SUBJECTS AND METHODS: We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following: 1. The percentage of responses left unanswered; 2. A factorial analysis of the main components; 3. Cronbach's alpha coefficient. RESULTS: We interviewed 20 patients and 12 experts; these results were later used to classify the above mentioned aspects in order of priority according to the frequency with which they appeared in the surveys. Then, we elaborated the questionnaire with four areas or subscales by including the questions or items in these categories: I. Physical status (17 items); II. Emotional status (13 items); III. Activities of daily living (13 items); IV. Social and familial functions (13 items). After the pilot study 38 items were reorganised into eight domains, according to the factorial analysis: 1. Physical problems; 2. Communication; 3. Cognition; 4. Emotions; 5. Feelings; 6. Activities of daily living; 7. Familial functions; 8. Social functions. They displayed high coefficients of internal consistency. CONCLUSIONS: We developed a new scale for evaluating the quality of life for stroke patients and it is now ready to undergo its validation process.

Desarrollo de una escala para evaluar la calidad de vida en supervivientes a un ictus / The development of a scale to evaluate the quality of life in stroke survivors

The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following...(AU)

Desarrollo de una escala para evaluar la calidad de vida en los supervivientes a un ictus / The development of a scale to evaluate the quality of life in stroke survivors

Introducción. La selección de una medida para evaluar el resultado de las intervenciones terapéuticas en los pacientes con ictus ha tenido un problema conceptual en la necesidad de detectar un amplio intervalo de deficiencias, discapacidades y minusvalías, como parte de un modelo basado en el paciente, y un problema metodológico en la falta de atención sistemática para el desarrollo de instrumentos estándares. Objetivo. Para resolver estas limitaciones realizamos este trabajo, con el objetivo de desarrollar una escala para evaluar la calidad de vida en los supervivientes a un ictus. Sujetos y métodos. Seguimos una metodología estandarizada por otros autores, que se basa en la opinión de los pacientes y los cuidadores para generar los ítems a incluir. Ésta tiene varias etapas, que incluyen: entrevistas individuales a pacientes, cuidadores y expertos, grupos focales con pacientes y expertos, análisis cuantitativo y cualitativo de estas entrevistas, dos paneles de consenso para la confección del instrumento y prueba piloto para reducir y agrupar los ítems en una muestra de 50 pacientes. Para reducir y agrupar los ítems tuvimos en cuenta: 1. El porcentaje de respuestas en blanco; 2.El análisis factorial de componentes principales, y 3. El coeficiente de Cronbach. Resultados. Entrevistamos a 20 pacientes y 12 expertos; con esos resultados, ordenamos los aspectos mencionados en orden de prioridad según la frecuencia de aparición en las encuestas. Posteriormente, confeccionamos el cuestionario con cuatro áreas o subescalas, que incluían las preguntas o ítems en las siguientes categorías: I. Estado físico (17 ítems); II. Estado emocional (13 ítems); III. Actividades de la vida diaria (13 ítems); IV. Funciones sociofamiliares (13 ítems). Después del estudio piloto se reorganizaron 38 ítems en ocho dominios, de acuerdo al análisis factorial: 1.Problemas físicos; 2. Comunicación; 3. Cognición; 4. Emociones; 5. Sentimientos; 6. Actividades de la vida diaria; 7. Funciones familiares; 8. Funciones sociales. Mostraron altos coeficientes de consistencia interna. Conclusión. Se ha desarrollado una nueva escala para evaluar la calidad de vida para el ictus, que se encuentra lista para su proceso de validación (AU)

Prevalencia del hipotiroidismo del anciano en un área de atención primaria de Ciudad de La Habana / Prevalence of hyperthyroidism in the elderly in a primary attention area of the city of Havana

El hipotiroidismo constituye un problema prevalente y subvalorado en los ancianos, y por no conocer la frecuencia de esta enfermedad en población general cubana, decidimos realizar el presente estudio. Entre los pacientes atendidos en un Grupo Básica de Trabajo del policlínico "Alumna Aleida Fernández Chardiet" (Municipio Lisa-Ciudad de La Habana) que atiende 1 912 ancianos, se seleccionaron 71 por muestreo simple aleatorio monoetápico, a los cuales se le realizaron determinaciones de hormonas tiroideas por radioinmunoanálisis (Kits diagnósticos del Instituto Nacional de Endocrinología, Ciudad de La Habana, Cuba). Los resultados fueron incluidos en una aplicación realizada en Foxpro 2.0 para DOS y analizados en Epi-info 6.04 (CDC-Atlanta). El 30,9 porciento de los ancianos presentó hipotiroidismo, lo cual es muy superior a lo señalado en otros estudios. El 1.3 porciento de los ancianos presentó hipotiroidismo clínico, con predominio de pacientes del sexo femenino (p<0.001). La prevalencia del hipotiroidismo en ancianos atendidos en el nivel primario fue significativamente elevada, con amplio predominio de casos subclínicos y del sexo femenino. Se requieren estudios que profundicen en el conocimiento de esta enfermedad en los ancianos cubanos (AU)