RESUMEN

The proportion of the Latin American population above age 65 y is expected to rise substantially. To better define the prevalence of infectious diseases and micronutrient deficiencies, assess immunological status, and evaluate associations between nutritional status and infection, we performed a cross-sectional study of elderly Ecuadorians in a low-income peri-urban community in Quito, Ecuador. Culturally adapted questionnaires, delayed type hypersensitivity (DTH) skin response, micronutrient, and immunological assays were performed in randomly selected Ecuadorians aged > or = 65 y. Multiple linear and logistic regression models were developed to assess relationships between micronutrient concentrations and history of infection, DTH, and immune function. Participants (n = 352; mean age +/- SD, 74.4 +/- 6.4 y) recalled recent episodes of colds/influenza-like syndromes (62.8%), cough (61.0%), urinary tract infection (37.9%), diarrhea (32.2%), fever (24.1%), and pneumonia (3.5%). A prospective substudy of respiratory infections (RI) in 203 elderly revealed similar findings. Colds and pneumonia occurred in 42.8 and 7.9% of participants, respectively, during 737 person-weeks of observation (3.6 +/- 1.1 wk per person). Anemia and micronutrient deficiencies, especially for vitamins C, D, B-6, and B-12 and folic acid and zinc, were common. Plasma vitamin C was associated with interferon-gamma (IFNgamma) (P < 0.01) and zinc with IFNgamma and interleukin-2 (each P < 0.0001). RI history was associated with any micronutrient deficiency (P < 0.001). The burden of infectious diseases, micronutrient deficiencies, and anemia was substantial in this elderly Ecuadorian population. Deficiencies of essential vitamins and minerals place these elderly adults at risk for infections through their negative impact on immune function.

Asunto(s)

Micronutrientes/deficiencia , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/inmunología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Recolección de Datos , Diarrea/complicaciones , Ecuador , Femenino , Humanos , Hipersensibilidad Tardía/epidemiología , Hipersensibilidad Tardía/inmunología , Inmunidad Innata , Modelos Logísticos , Masculino , Desnutrición , Micronutrientes/sangre , Oportunidad Relativa , Infecciones del Sistema Respiratorio/complicaciones , Pruebas Cutáneas , Encuestas y Cuestionarios

RESUMEN

The number of elderly people is increasing in less-developed countries. Although nutritional deficiencies and infectious diseases are generally more prevalent in resource-poor countries, the health and nutritional status of the elderly in South America in general, and in Ecuador, in particular, remains largely unstudied. The objective of the present study was to assess the nutritional, immunological and health status of elderly Ecuadorians. A cross-sectional study was conducted to evaluate a sample of elderly Ecuadorians with 24 h dietary recalls, biochemical and anthropometric measurements, delayed type hypersensitivity skin response and a health questionnaire. The 145 elders who enrolled had a mean age of 74.3 (SD 6.9) years. Of the subjects, 52 % exhibited BMI >or=25 kg/m(2), whereas 9.1 % had BMI

Asunto(s)

Estado de Salud , Hipersensibilidad Tardía/epidemiología , Estado Nutricional/fisiología , Anciano , Anciano de 80 o más Años , Antígenos/inmunología , Índice de Masa Corporal , Estudios Transversales , Dieta , Ecuador/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Hipersensibilidad Tardía/inmunología , Masculino , Micronutrientes/administración & dosificación , Micronutrientes/sangre , Persona de Mediana Edad , Pobreza , Pruebas Cutáneas , Salud Urbana , Vitaminas/administración & dosificación , Vitaminas/sangre