Enfermedad crónica, mortalidad, discapacidad y pérdida de movilidad en ancianos españoles: estudio FRADEA / Chronic disease, mortality and disability in an elderly Spanish population: The FRADEA study

Introducción: El objetivo de nuestro trabajo fue analizar la asociación entre las principales enfermedades crónicas y la multimorbilidad, con mortalidad, discapacidad incidente en actividades básicas de la vida diaria y pérdida de movilidad en ancianos. Material y métodos: Novecientos cuarenta y tres participantes del estudio FRADEA con datos en la visita basal de enfermedades crónicas, y en la segunda visita de mortalidad, discapacidad incidente y pérdida de movilidad. Se analizó la asociación cruda y ajustada por edad, sexo y discapacidad previa entre el recuento de enfermedades crónicas total, el recuento de 14 enfermedades prevalentes preseleccionadas y la presencia de 2 o más de estas últimas (multimorbilidad) con los eventos adversos de salud referidos. Resultados: Los participantes con mayor recuento de enfermedades totales (OR 1,11; IC 95% 1,02-1,22), así como seleccionadas (OR 1,19; IC95% 1,03-1,38) tuvieron un mayor riesgo ajustado de mortalidad, pero no de discapacidad incidente ni pérdida de movilidad. Los sujetos con multimorbilidad tuvieron mayor riesgo ajustado, aunque no significativo, de mortalidad (HR 1,45; IC95% 0,87-2,43), frente a los que no la tenían. El tiempo medio libre de discapacidad incidente en participantes sin y conmultimorbilidad fue de 846 ± 34 y 731 ± 17 días respectivamente (log-rank 2 7,45; p = 0,006), y sin y con pérdida de movilidad fue de 818 ± 32 y 696 ± 13 días respectivamente (log-rank 2 10,99; p = 0,001). Conclusiones: La multimorbilidad no se asocia de manera ajustada con mortalidad, discapacidad incidente ni pérdida de movilidad en mayores de 70 años, aunque sí con mortalidad si se considera el recuento de enfermedades crónicas de manera lineal (AU)

Introduction: The objective of this study was to analyse the relationships between the major chronic diseases and multiple morbidity, with mortality, incident disability in basic activities of daily living, and loss of mobility in the elderly. Material and methods: A total of 943 participants were selected from the FRADEA Study, using available baseline data of chronic diseases, and at the follow-up visit of mortality, incident disability, and loss of mobility. The analysis was made of the unadjusted and adjusted association between the number of chronic diseases, the number of 14 pre-selected diseases, and the presence of two or more chronic diseases (multiple morbidity) with adverse health events recorded. Results: Participants with a higher number of diseases (OR 1.11; 95% CI: 1.02-1.22), and 14 preselected diseases (OR 1.19; 95% CI: 1.03-1.38) had a higher adjusted mortality risk, but not a higher incident disease or mobility loss risk. Subjects with multiple morbidity had a higher non-significant mortality risk (HR 1.45; 95% CI: 0.87-2.43), than those without multiple morbidity. Disability-free mean time in participants with and without multiple morbidity was 846 ± 34 and 731 ± 17 days, respectively (Log-rank 2 7.45. P =.006), and with our without mobility loss was 818±32 and 696±13 days, respectively (Log rank 2 10.99. P =.001). Conclusions: Multiple morbidity was not associated with mortality, incident disability in ADL, or mobility loss in adults older than 70 years, although if mortality is taken into account, the number of chronic diseases is linear (AU)

[Chronic disease, mortality and disability in an elderly Spanish population: the FRADEA study]. / Enfermedad crónica, mortalidad, discapacidad y pérdida de movilidad en ancianos españoles: estudio FRADEA.

INTRODUCTION: The objective of this study was to analyse the relationships between the major chronic diseases and multiple morbidity, with mortality, incident disability in basic activities of daily living, and loss of mobility in the elderly. MATERIAL AND METHODS: A total of 943 participants were selected from the FRADEA Study, using available baseline data of chronic diseases, and at the follow-up visit of mortality, incident disability, and loss of mobility. The analysis was made of the unadjusted and adjusted association between the number of chronic diseases, the number of 14 pre-selected diseases, and the presence of two or more chronic diseases (multiple morbidity) with adverse health events recorded. RESULTS: Participants with a higher number of diseases (OR 1.11; 95% CI: 1.02-1.22), and 14 pre-selected diseases (OR 1.19; 95% CI: 1.03-1.38) had a higher adjusted mortality risk, but not a higher incident disease or mobility loss risk. Subjects with multiple morbidity had a higher non-significant mortality risk (HR 1.45; 95% CI: 0.87-2.43), than those without multiple morbidity. Disability-free mean time in participants with and without multiple morbidity was 846±34 and 731±17 days, respectively (Log-rank χ(2) 7.45. P=.006), and with our without mobility loss was 818±32 and 696±13 days, respectively (Log rank χ(2) 10.99. P=.001). CONCLUSIONS: Multiple morbidity was not associated with mortality, incident disability in ADL, or mobility loss in adults older than 70 years, although if mortality is taken into account, the number of chronic diseases is linear.

Evaluación clínica de factores de riesgo de enfermedad renal en Formosa (Argentina): a propósito del día mundial de riñón 2012 / Clinical evaluation of risk factors for renal disease in Formosa (Argentina): in connection with World Kidney Day 2012

Introducción: El Día Mundial del Riñón es una iniciativa de la Sociedad Internacional de Nefrología y la Federación internacional de Fundaciones Renales para disminuir problemas relacionados con la enfermedad renal y crear conciencia sobre este tema. En 2012, el Ministerio de Desarrollo Humano de Formosa, Argentina, organizó una evaluación clínica gratuita dirigida especialmente a quienes supieran que presentaban algún factor de riesgo para enfermedad renal. Método: Durante una semana, en 4 consultorios se entrevistó a los participantes. Se tomó nota de los antecedes, se midieron los siguientes parámetros: presión arterial, circunferencia abdominal, niveles de urea, creatinina y glucemia. Se realizaron ecografía renal y análisis de orina. Los resultados se analizaron estadísticamente. Resultados: Se tomaron los datos de 63 personas. Media de edad; 49.8 ± 14.2. Cuarenta y tres (68.3%) participantes informaron tener antecedentes patológicos. Catorce (22%) muestras de orina y 16 (25%) ecografías renales resultaron con indicadores de patología. Se detectaron 24 personas (38.1%) con HTA, 9 lo desconocían, 2 con diabetes no informada. Treinta y cuatro(54%) sujetos mostraron MDRD <- 80. Treinta y siete (58%) participantes con circunferencia abdominal mayor a los valores recomendados. Diez (15.9%) hombres presentaron creatinina >- 1,40/mg/dl y 3(4.8%) nivel de glucemia >- 126 mg/dI. Conclusión: Treinta y siete pacientes fueron invitados a consultar con un especialista por presentar indicador de insuficiencia renal o factor de riesgo. Se deberían repetir y ampliar estas acciones para diseñar programas sanitarios, detectar la enfermedad renal y crear conciencia sobre hábitos de vida saludable.

World Kidney Day is an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations to reduce the impact of kidney disease and raise awareness about it. In 2012, the Ministry of Human Development of Formosa, Argentina, organized a free screening especially targeted to those who thought could had some risk factor for kidney disease. Methods: During the Kidney week 2012, 3 nephrologists and 1 general physician interviewed the participants. Blood pressure and abdominal circumference were measured; urine and blood samples were evaluated for urea, creatinine and glycaemia levels, and renal echography was performed. Results were statistically analyzed. Results: Data from 63 participants were used in this study. Mean age: 49.8 years ± 14.2. 14 (22%) urine samples showed pathological signs and 16(25%) renal ultrasound tests were pathological. 24(38.1%) presented HTA, 9 people were unaware of this condition. We found 2 cases of uninformed diabetes. 34(54%) participants had MDRD <-80 and 37(58.7%) had abdominal circumference above safe parameters. Ten men (15.9%) had creatinine >- 1,40/mg/dl and 3(4.8%) participants had glucose level >- 126 mg/dl. Conclusion: Thirty seven participants were referred to specialist. Screening should be carried out for early detection of kidney disease, to obtain information for the design and implementation of public health programs and to promote healthy habits.

Evaluación clínica de factores de riesgo de enfermedad renal en Formosa (Argentina): a propósito del día mundial de riñón 2012 / Clinical evaluation of risk factors for renal disease in Formosa (Argentina): in connection with World Kidney Day 2012

Introducción: El Día Mundial del Riñón es una iniciativa de la Sociedad Internacional de Nefrología y la Federación internacional de Fundaciones Renales para disminuir problemas relacionados con la enfermedad renal y crear conciencia sobre este tema. En 2012, el Ministerio de Desarrollo Humano de Formosa, Argentina, organizó una evaluación clínica gratuita dirigida especialmente a quienes supieran que presentaban algún factor de riesgo para enfermedad renal. Método: Durante una semana, en 4 consultorios se entrevistó a los participantes. Se tomó nota de los antecedes, se midieron los siguientes parámetros: presión arterial, circunferencia abdominal, niveles de urea, creatinina y glucemia. Se realizaron ecografía renal y análisis de orina. Los resultados se analizaron estadísticamente. Resultados: Se tomaron los datos de 63 personas. Media de edad; 49.8 ± 14.2. Cuarenta y tres (68.3%) participantes informaron tener antecedentes patológicos. Catorce (22%) muestras de orina y 16 (25%) ecografías renales resultaron con indicadores de patología. Se detectaron 24 personas (38.1%) con HTA, 9 lo desconocían, 2 con diabetes no informada. Treinta y cuatro(54%) sujetos mostraron MDRD <- 80. Treinta y siete (58%) participantes con circunferencia abdominal mayor a los valores recomendados. Diez (15.9%) hombres presentaron creatinina >- 1,40/mg/dl y 3(4.8%) nivel de glucemia >- 126 mg/dI. Conclusión: Treinta y siete pacientes fueron invitados a consultar con un especialista por presentar indicador de insuficiencia renal o factor de riesgo. Se deberían repetir y ampliar estas acciones para diseñar programas sanitarios, detectar la enfermedad renal y crear conciencia sobre hábitos de vida saludable.(AU)

World Kidney Day is an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations to reduce the impact of kidney disease and raise awareness about it. In 2012, the Ministry of Human Development of Formosa, Argentina, organized a free screening especially targeted to those who thought could had some risk factor for kidney disease. Methods: During the Kidney week 2012, 3 nephrologists and 1 general physician interviewed the participants. Blood pressure and abdominal circumference were measured; urine and blood samples were evaluated for urea, creatinine and glycaemia levels, and renal echography was performed. Results were statistically analyzed. Results: Data from 63 participants were used in this study. Mean age: 49.8 years ± 14.2. 14 (22%) urine samples showed pathological signs and 16(25%) renal ultrasound tests were pathological. 24(38.1%) presented HTA, 9 people were unaware of this condition. We found 2 cases of uninformed diabetes. 34(54%) participants had MDRD <-80 and 37(58.7%) had abdominal circumference above safe parameters. Ten men (15.9%) had creatinine >- 1,40/mg/dl and 3(4.8%) participants had glucose level >- 126 mg/dl. Conclusion: Thirty seven participants were referred to specialist. Screening should be carried out for early detection of kidney disease, to obtain information for the design and implementation of public health programs and to promote healthy habits.(AU)