Is there interest of Mexican adults in being prepared should they develop Alzheimer's or other dementia? / ¿Existe interés en adultos mexicanos de preparase en caso de llegar a padecer Alzheimer u otra demencia?

Abstract Introduction Alzheimer's disease, as well as other dementias, cause a progressive deterioration of cognitive functions, preventing patients from making decisions and having control over themselves in an advanced stage of the disease. Objective To explore some expectations, wishes and preferences in a sample of mature adults should they develop Alzheimer or other dementia. Method We surveyed 368 mature Mexican adults without dementia using a large survey created by the authors and used in a previous study; data were collected in some public places where mature people were invited to participate. The survey was completed from July 2019 to August 2020. Results Although most participants had considered they might suffer from dementia in the future, less than half had communicated their wishes to their relatives about future medical treatments in case they could no longer decide for themselves; very few had prepared a written advance directive. Most participants agreed that patients should know their initial diagnosis, mainly to be able to prepare themselves. The main reason given by those who would prefer to hide the diagnosis was to avoid suffering. Discussion and conclusion Our results highlight the need for health professionals to promote discussion with people about the possibility of suffering from dementia, as well as the importance of making decisions in advance, and letting their relatives know about them.

Resumen Introducción La enfermedad de Alzheimer, así como las otras demencias, causan un deterioro progresivo de las funciones cognitivas, evitando que en una etapa avanzada de la enfermedad los pacientes puedan tomar decisiones y tener control sobre sí mismos. Objetivo Explorar algunas expectativas, deseos y preferencias en una muestra de adultos maduros en caso de que llegaran a desarrollar Alzheimer u otra demencia. Método Encuestamos a 368 adultos mexicanos maduros sin demencia usando una encuesta creada por los autores y utilizada en un estudio anterior; los datos se recopilaron en algunos lugares públicos donde se invitó a las personas a participar. La encuesta se aplicó de julio de 2019 a agosto de 2020. Resultados Aunque la mayoría de los participantes había considerado que podría sufrir demencia en el futuro, menos de la mitad había comunicado sus deseos a sus familiares sobre futuros tratamientos médicos en caso de que ya no pudieran decidir por sí mismos; muy pocos habían preparado una voluntad anticipada por escrito. La mayoría de los participantes estuvo de acuerdo en que los pacientes deben conocer su diagnóstico inicial, principalmente para poder prepararse. La principal razón aducida por quienes preferirían ocultar el diagnóstico fue el deseo de evitar sufrimiento. Discusión y conclusión Nuestros resultados destacan la necesidad de que el personal de salud promueva la discusión con las personas sobre la posibilidad de padecer demencia, así como la importancia de tomar decisiones por anticipado e informar de ellas a sus familiares.

Secular trends in age at menarche in 20th century Mexico: Differences by ethnicity, area of residency, and socioeconomic status.

OBJECTIVES: This study aims to assess the secular trend in age at menarche (AAM) in Mexico over the 20th century, and compare the patterns according to area of residence (rural/urban), socioeconomic status (SES), and ethnicity (indigenous/nonindigenous). METHODS: Data on AAM from 24 380 women aged ≥20 years born between 1906 and 1986 were obtained from the Mexican National Health and Nutrition Survey 2006. Birth cohorts were compared to test for a secular trend and differences in mean AAM by area of residence, SES, and ethnicity were evaluated using the Welch test for heterogeneous variances followed by Tamhane T2 for post hoc comparisons. RESULTS: Mean AAM declined from 13.3 years among Mexican women born before the 1940s to 12.56 years among those born in the 1980s. Across birth cohorts, urban women had significantly earlier AAM than their rural counterparts. Nonindigenous urban women reached menarche the earliest and rural indigenous women the latest of all groups. Nonindigenous urban residents experienced a comparatively earlier decline, while that for the indigenous rural women occurred last. High SES women reached menarche the earliest and low SES women the latest. The historical decline in AAM for high and medium SES groups occurred relatively early, whereas that for the low SES occurred last. CONCLUSIONS: Mean AAM was associated with area of residence, ethnicity, and SES. Our findings indirectly suggest that advances in living conditions experienced in Mexico during the 20th century appear to have been insufficient to overcome the social and biological inequalities accumulated over centuries in some groups.

Validación de la versión castellana del Inventario de Fatalismo de Powe en población mexicana con cáncer / Validation of the Castilian version of Powe’s Fatalism Inventory in a Mexican population with cancer

Objetivo: validar la versión en español del Inventario de Fatalismo de Powe (SPFI) en población mexicana con cáncer. Método: Se aplicó el SPFI a 133 mujeres con cáncer de mama. Se realizó un análisis factorial con rotación Oblimin. Posteriormente se evaluó la consistencia interna con el coeficiente Alfa de Cronbach y por último se realizaron análisis de correlación entre los factores del cuestionario. El instrumento resultante se nombró Inventario de Fatalismo de Powe en Español-Cáncer (IFPE-C).Resultados: Se eliminaron siete de los 15 reactivos originales y se conservaron ocho, todos ellos con cargas factoriales superiores a 0,40. Se obtuvo una estructura de tres factores que explicaron el 73,7% de la varianza y se llamaron: Inutilidad del tratamiento con un alfa=0,85, Predestinación con un alfa=0,918 y Pensamientos de muerte con un alfa=0,73. La consistencia interna para la escala global fue de alfa =0,80. Se obtuvieron correlaciones estadísticamente significativas entre los factores. Conclusión: el IFPE-C demostró ser un instrumento valido y confiable, que puede ser utilizado tanto en entornos clínicos como de investigación para identificar las creencias fatalistas acerca del cáncer de los pacientes

Objective: To validate the Spanish version of Powe’s Fatalism Inventory (SPFI) in Mexican population with cancer.Method: The SPFI was applied to 133 women with breast cancer. A factorial analysis with Oblimin rotation was conducted, Then, the internal consistency was evaluated with the Cronbach’s Alpha coefficient and finally, correlation analyses among the questionnaire factors were conducted. The final instrument was named Spanish Powe Fatalism Inventory-Cancer (IFPE-C). Results: Seven of the original 15 items were eliminated and eight were retained, all with factor loads greater than 0.40. We obtained a structure of three factors that explained 73.7% of the variance and were called: Uselessness of the treatment with alfa = 0.85, Predestination with alfa = 0.918 and Thoughts of death with alfa = 0.73. The internal consistency for the global scale was alfa = 0.80. Statistically significant correlations were obtained between the factors. Conclusion: the IFPE-C proved to be a valid and reliable instrument that can be used both in clinical and research settings to identify fatalistic beliefs about cancer of patients

Mexican beliefs and attitudes toward menopause and menopausal-related symptoms.

The objective of this study was to explore the beliefs and attitudes toward menopause among young and middle-aged Mexican women and men, as well as the menopausal-related symptoms that middle-aged women report or expect and that other participants think a menopausal woman experiences. The beliefs about and attitudes toward Menopause Questionnaire and the Greene Climacteric Scale were answered by 395 Mexicans between the ages of 20 and 60 years. Comparing middle-aged participants, the most negative attitudes toward menopause were held by surgically menopausal women, and the most positive attitudes by naturally postmenopausal women. Younger participants showed more negative attitudes when compared to those in middle age (with exception of surgically menopausal women). There was a positive correlation between negative attitudes and menopausal-related symptoms either experienced by perimenopausal and naturally postmenopausal women, or expected by young and premenopausal women. No significant correlation was found between attitudes and symptoms in the groups of surgically menopausal women or the men. These findings are discussed in light of differences between genders and age cohorts.