Anthropometric measures and nutritional status in a healthy elderly population.

BACKGROUND: Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people. METHODS: The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS)". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length. RESULTS: Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p < 0.05), and the mean heights were 1.52 m for women and 1.63 m for men (p < 0.05). Age related changes in anthropometric values were identified. BMI values indicated that 62.3% of the population was overweight, and 73.6% of women and 16.5% of men had high fat tissue distribution. CONCLUSION: Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.

Coste de la atención al paciente diabético-hipertenso en el primer nivel de atención / Cost of caring for the diabetic-hypertensive patient in primary care

Objetivo. Determinar el coste de la atención en el primer nivel de atención del paciente diabético-hipertenso. Diseño. Se trata de un análisis de coste realizado en unidades de medicina familiar en México. Emplazamiento. Medicina familiar en México. Participantes. Pacientes con diabetes-hipertensión. Medición. Incluye el perfil de uso de los servicios y el coste de la atención. El perfil se definió como el promedio anual de uso de los servicios de primer nivel, el coste unitario se calculó por motivo de uso en cada uno de los servicios utilizados, considerando los insumos fijos y variables; el coste promedio por motivo de atención se integró a partir de la relación uso-coste y el coste promedio anual de la suma de los costes promedio por motivo de atención. Resultados. El coste promedio anual en la consulta de medicina familiar fue de 180,65 € (intervalo de confianza [IC] del 95%, 168,31-193), en el laboratorio de 48,99 € (IC del 95%, 44,85-53,18) y en el resto de los servicios de primer nivel de 41,33 € (IC del 95%, 30,19-52,46). El coste promedio anual por paciente en primer nivel de atención fue de 271 € (IC del 95%, 243,36-298,65). Conclusión. El coste de la atención del paciente diabético-hipertenso en primer nivel se concentra en la medicina de familia y el laboratorio

Objective. To determine the cost of caring for the diabetic-hypertensive patient in primarycare. Design. A cost analysis carried out in family medicine units in Mexico. Setting. Family medicine units in Mexico. Participants. Patients with diabetes andhypertension. Measurements. Include the profile of use of the services and the cost of the care. The profile is defined as the average annual use of primary care services, the unit cost is calculated by reason for use in each of the services used, taking the fixed and variable consumables into account; the average cost by reason for care is calculated from use-cost ratio and the mean annual cost from the total average cost by reason for the care. Results. The mean annual cost in the family doctor clinic was €180.65 (95% confidence interval [CI], 168.31-193), in the laboratory, €48.99 (95% CI, 44.85-53.18), and in the rest of the primary care services, €41.33 (95% CI, 30.19-52.46). The mean annual primary care cost per patient was €271 (95% CI, 243.36- 298.65). Conclusion. The primary care costs of the diabetic-hypertensive patient are concentrated in the family doctor and laboratory services

[Cost of caring for the diabetic-hypertensive patient in primary care]. / Coste de la atención al paciente diabético-hipertenso en el primer nivel de atención.

OBJECTIVE: To determine the cost of caring for the diabetic-hypertensive patient in primary care. DESIGN: A cost analysis carried out in family medicine units in Mexico. SETTING: Family medicine units in Mexico. PARTICIPANTS: Patients with diabetes and hypertension. MEASUREMENTS: Include the profile of use of the services and the cost of the care. The profile is defined as the average annual use of primary care services, the unit cost is calculated by reason for use in each of the services used, taking the fixed and variable consumables into account; the average cost by reason for care is calculated from use-cost ratio and the mean annual cost from the total average cost by reason for the care. RESULTS: The mean annual cost in the family doctor clinic was euro180.65 (95% confidence interval [CI], 168.31-193), in the laboratory, euro48.99 (95% CI, 44.85-53.18), and in the rest of the primary care services, euro41.33 (95% CI, 30.19-52.46). The mean annual primary care cost per patient was euro271 (95% CI, 243.36- 298.65). CONCLUSION: The primary care costs of the diabetic-hypertensive patient are concentrated in the family doctor and laboratory services.