Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol.

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].

Relationship between Falls and the Use of Medications and Diseases in an Otago Exercise Programme in Old People Living in the Community in Spain.

(1) Background: Falls are a significant health problem among older adults, and can result in severe injuries, disability, and even death. In Spain, the prevalence of falls is lower if the person lives in the community than if they are institutionalized. Research has shown that exercise is an effective strategy for reducing the risk of falls among older adults. The objective of this study was to study the influence of a multicomponent exercise intervention on falls in people between 65 and 80 years of age despite the presence of diseases and drug use that are risk factors for falls; (2) Methods: This is a quasi-experimental study that focuses on people aged 65-80 who attended 21 primary healthcare centres. Target: Inclusion criteria were people between 65 and 80 years of age, living in the community with independent ambulation, and who were served by the healthcare centre of their region. Variables analysed: The number and characteristics of falls, sociodemographic, drug use, and previous diseases; (3) Results: The drugs associated with falls are benzodiazepines (OR 2.58), vasodilators (OR = 2.51), and psychotropics (OR = 1.61). For one of the years, a relationship was found between the consumption of antidepressants and falls (OR = 1.83). The associated diseases were mental and behavioural (OR = 2.53); (4) Discussion: The intervention has been related to the reduction in falls in people who consumed benzodiazepines, vasodilators, and psychotropics and in people with mental disorders; (5) Conclusion: This research concludes the importance of the implementation of the Otago Exercise Programme in the prevention of falls in the elderly.

Weight Loss and Improvement of Metabolic Alterations in Overweight and Obese Children Through the I2AO2 Family Program: A Randomized Controlled Clinical Trial.

Childhood obesity is a major public health concern. We wanted to evaluate the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education to achieve weight loss and improve metabolic parameters in overweight and obese children. A randomized, controlled clinical trial with long-term follow-up (24 months) was conducted at a community care center in overweight and obese individuals aged 6-12 years. A sample of 108 children was divided into an experimental and a control group receiving a standard care program. The experimental groups received a 12-month interdisciplinary program; the results were evaluated at 4 months, the end of the intervention, and at follow-up 12 months later. Anthropometric and biological marker measurements related to metabolic alterations, dyslipidemia (based on total cholesterol), hyperglycemia, fasting glycaemia, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in blood were recorded. The intervention had a significant effect (p < 0.001) in terms of decreased body mass index, skinfolds, and waist and arm circumferences. These changes were accompanied by biochemical changes underlying an improvement in metabolic parameters, such as a significant reduction in total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hyperglycemia and a significant increase in high-density lipoprotein-cholesterol. These effects were still significant for markers of excess weight or obesity in the experimental group 12 months after the end of the intervention, suggesting that an enduring change in healthy lifestyles had been maintained period. This interdisciplinary, nurse-led program helped to reduce childhood and adolescent excess weight and obesity and had long-lasting effects.

Effectiveness of an Interdisciplinary Program Performed on Obese People Regarding Nutritional Habits and Metabolic Comorbidity: A Randomized Controlled Clinical Trial.

Obesity is an important public health problem. The combined use of different therapies performed by an interdisciplinary group can improve the management of this health issue. The main goal of this research is to determine the effectiveness of a multidisciplinary program based on healthy eating, exercise, cognitive-behavioral therapy, and health education in improving metabolic comorbidity, Body Mass Index (BMI), and nutritional habits among obese adults, at short (12 months) and long term (24 months). A randomized controlled clinical trial was conducted at a community care center between February 2014 and February 2016. A random sampling was done (299), total population (3262). A sample of 74 subjects diagnosed with obesity (experimental group, n = 37 and control group, n = 37) was conducted. Inclusion criteria: obese people (BMI: >30 kg/m2) with metabolic comorbidity and bad nutritional habits. Exclusion criteria: other comorbidities. A 12-month interdisciplinary program (with pre-test, 12 months and 24 months of follow-up) was applied. Intervention is based on healthy eating, exercise, and cognitive behavioral therapy. The intervention had a positive effect on nutritional habits (F2;144 = 115.305; p < 0.001). The experimental group increased fruit and vegetable intake (F2;144 = 39.604, p < 0.001), as well as fortified foods (F2;144 = 10,076, p < 0.001) and reduced fats, oils, and sweets F2;144 = 24,086, p < 0.001). In the experimental group, a BMI reduction of 2.6 to 24 months was observed. At follow-up, no participant had inadequate nutritional habits, compared to 35.1% of the control group (χ22 = 33,398; p < 0.001). There was also a positive response of metabolic comorbidities in the intervention group. The interdisciplinary program improved all participants' metabolic parameters, BMI, and nutritional habits while maintaining the long-term effects (24 months).

Short-medium-long-term efficacy of interdisciplinary intervention against overweight and obesity: Randomized controlled clinical trial.

AIM: The aim of the study is to evaluate the efficacy of a nurse-led interdisciplinary programme based on healthy eating, physical exercise, and cognitive behavioural therapy applied to anthropometric and cardiovascular measures, which are related to obesity in short, medium, and long term. METHODS: We conducted a randomised controlled clinical trial with 74 obese and overweight participants (experimental group, n = 37; control group, n = 37). An interdisciplinary programme of 12 months was applied and coordinated by a nurse. Anthropometric and cardiovascular measures were taken at the pretest stage, every 6 months during the programme, and 1 year after it finished. RESULTS: A beneficial effect was found regarding all anthropometric parameters. Tests for weight (F3;207  = 93.27; P < .001) and body mass index (F3;207  = 89.95; P < .001) indicate efficacy of intervention: The experimental group had a weight loss of 7.2 kg (-8.3%) compared to a 0.9 kg (+1.0%) gained in the control group. Systolic (F3;207  = 37.06; P < .001) and diastolic (F3;216  = 57.31; P < .001) blood pressure improved greatly in the experimental group. Forced vital capacity was also increased (F2;138  = 15.51; P < .001). CONCLUSION: The interdisciplinary programme coordinated by nurses improved the health of participants, maintaining long-term effects.

Impact of the I2AO2 interdisciplinary program led by nursing on psychological comorbidity and quality of life: Randomized controlled clinical trial.

OBJECTIVE: Obesity is an entity of highly prevalent multifactorial origin with associated metabolic and psychological comorbidity, causing a negative impact on the quality of life of those who suffer from it. The objective is to evaluate the impact of an interdisciplinary program for nurse-led obesity on quality of life related to health and anxiety. METHODS: Randomized controlled clinical trial with a sample of 74 subjects diagnosed with obesity (EG: n=37; CG: n=37). The intervention consisted of a 12-month interdisciplinary program (with pre-test, 12month and 24month follow-up) coordinated by nurses. RESULTS: The anxiety analysis shows that there is no effect of the intervention on S-STAI (F2; 144=0.246; p=0.782), which has increased in both groups. However, there is an effect on T-STAI (F2; 144=8872; p<0.001), which only increases in the control group. The interdisciplinary program has significantly improved health-related quality of life (SF-36), both in physical health parameters as well as in mental health. CONCLUSION: The interdisciplinary program led by nursing professionals has improved the quality of life related to health and has prevented the increase of anxiety-trait in participants, maintaining the long-term effects.

[Prevalence of metabolic syndrome and cardiovascular risk in an urban area of Murcia]. / Prevalencia de síndrome metabólico y riesgo cardiovascular en un área urbana de Murcia.

INTRODUCTION: It is extensive scientific literature that has defined the metabolic syndrome as a precursor of cardiovascular disease. OBJECTIVES: To estimate the prevalence of metabolic syndrome and cardiovascular risk in the population of a basic health area of Murcia. METHODS: Cross sectional study population of the district health "The Esparragal" random sample of the population between 18 and 86 years living in the area. Personal history were collected and held a relevant clinical, anthropometric data and analytics for the estimation of Metabolic Syndrome and Cardiovascular Risk following criteria dictated by the current literature, adjusted for sex and age. RESULTS: The mean age of the study population was 59.34 ± 14.79 years, with 52.5% males. The overall prevalence of metabolic syndrome criteria World Health Organization is presented 36.8%, a figure increased under International Diabetes Ferderation recommendations to 58.2% and according to National Cholesterol Education Program, an estimated 53.5%. The presentation of this syndrome is slightly higher in men (54.1 versus 52.8 %), and in parallel with increasing age (p < 0.001). The prevalence of people at high risk of cardiovascular disease is 32.1 % (95 % CI 29.4 to 34.8), with 45.2 % (95% CI 41.2 to 49.2) in men and 17.6% (95% CI 14.4 to 20.8) in women. DISCUSSION: The prevalence of metabolic syndrome and cardiovascular risk in the study population is the highest found in Spain in population studies, indicating an invaluable population on which preventive measures.

Introducción: Es extensa la literatura científica que ha definido al síndrome metabólico como precursor de la enfermedad cardiovascular. Objetivos: Estimar la prevalencia de Síndrome Metabólico y Riesgo Cardiovascular en la población de una zona básica de salud de Murcia. Métodos: Estudio poblacional de corte transversal de la zona básica de salud "El Esparragal", muestra aleatoria de la población entre 18 y 86 años residentes en dicha zona. Se recogieron los antecedentes personales y se llevo a cabo una evaluación clínica, antropométrica y analítica pertinente para la estimación de Síndrome Metabólico y el Riesgo Cardiovascular siguiendo criterios dictados por la literatura actual, ajustados a sexo y edad. Resultados: La edad media de la población estudiada resultó de 59,34±14,79 años, siendo el 52,5% varones. La prevalencia global de Síndrome Metabólico según criterios Organización Mundial de la Salud es del 36,8% presenta, cifra incrementada bajo recomendaciones International Diabetes Ferderation a un 58,2% y según National Cholesterol Education Program, se estimó un 53,5%. La presentación de dicho síndrome es ligeramente superior en varones (54,1 frente al 52,8%), y aumentando paralelamente con la edad (p.

Prevalencia de síndrome metabólico y riesgo cardiovascular en un área urbana de Murcia / Prevalence of metabolic syndrome and cardiovascular risk in an urban area of Murcia

Introducción: Es extensa la literatura científica que ha definido al síndrome metabólico como precursor de la enfermedad cardiovascular. Objetivos: Estimar la prevalencia de Síndrome Metabólico y Riesgo Cardiovascular en la población de una zona básica de salud de Murcia Métodos: Estudio poblacional de corte transversal de la zona básica de salud "El Esparragal", muestra aleatoria de la población entre 18 y 86 años residentes en dicha zona. Se recogieron los antecedentes personales y se llevo a cabo una evaluación clínica, antropométrica y analítica pertinente para la estimación de Síndrome Metabólico y el Riesgo Cardiovascular siguiendo criterios dictados por la literatura actual, ajustados a sexo y edad. Resultados: La edad media de la población estudiada resultó de 59,34±14,79 años, siendo el 52,5% varones. La prevalencia global de Síndrome Metabólico según criterios Organización Mundial de la Salud es del 36,8% presenta, cifra incrementada bajo recomendaciones International Diabetes Ferderation a un 58,2% y según National Cholesterol Education Program, se estimó un 53,5%. La presentación de dicho síndrome es ligeramente superior en varones (54,1 frente al 52,8%), y aumentando paralelamente con la edad (p<0,001). La prevalencia de personas con riesgo alto de Enfermedad Cardiovascular es de 32,1% (IC 95%: 29,4-34,8), siendo de 45,2% (IC95%: 41,2-49,2) en hombres y de 17,6% (IC95%: 14,4-20,8) en mujeres. Discusión: La prevalencia de síndrome metabólico y riesgo cardiovascular en la población estudiada es de las más altas halladas en España en estudios poblacionales, lo que indica una población inestimable sobre la cual aplicar medidas preventivas (AU)

Introduction: It is extensive scientific literature that has defined the metabolic syndrome as a precursor of cardiovascular disease. Objectives: To estimate the prevalence of metabolic syndrome and cardiovascular risk in the population of a basic health area of Murcia Methods: Cross sectional study population of the district health "The Esparragal" random sample of the population between 18 and 86 years living in the area. Personal history were collected and held a relevant clinical, anthropometric data and analytics for the estimation of Metabolic Syndrome and Cardiovascular Risk following criteria dictated by the current literature, adjusted for sex and age. Results: The mean age of the study population was 59.34 ± 14.79 years, with 52.5% males. The overall prevalence of metabolic syndrome criteria World Health Organization is presented 36.8%, a figure increased underInternational Diabetes Ferderation recommendations to 58.2% and according to National Cholesterol Education Program, an estimated 53.5%. The presentation of this syndrome is slightly higher in men (54.1 versus 52.8 %), and in parallel with increasing age (p < 0.001). The prevalence of people at high risk of cardiovascular disease is 32.1 % (95 % CI 29.4 to 34.8), with 45.2 % (95% CI 41.2 to 49.2) in men and 17.6% (95% CI 14.4 to 20.8) in women. Discussion: The prevalence of metabolic syndrome and cardiovascular risk in the study population is the highest found in Spain in population studies, indicating an invaluable population on which preventive measures (AU)