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1.
J Nutr Health Aging ; 23(3): 227-231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30820509

RESUMO

OBJECTIVES: The aim of this study was to determine the prevalence of Motoric Cognitive Risk (MCR) syndrome, describe associated risk factors and to determine the risk of progression to cognitive impairment after three years of follow-up, in a sample of Mexican older adults. DESIGN: A prospective panel study of health and aging in Mexico. SETTING AND PARTICIPANTS: Baseline and follow-up information was obtained from the Mexican Health and Aging Study's 2012 and 2015 waves. A total of 726 subjects aged 60 years or older with normal cognition at baseline were classified into 4 groups: 1) with MCR, 2) with memory complaint only, 3) with slow gait speed only and, 4) without MCR. Cox regression analysis controlling for confounder factors was performed to determine the risk of progression to cognitive impairment in the MCR group. MEASURES: Data such as gait speed, functional status and cognitive performance (standardized by age and sex in Mexican population) was collected. RESULTS: MCR prevalence was 14.3%. When compared with non-MCR subjects, the presence of MCR was associated with older age (p<0.01), lower educational status (p=0.05), having two or more comorbidities (p<0.05) and diabetes mellitus diagnosis (p<0.05). At follow-up and after adjusting for confounders, MCR was associated with a 2.4-fold increased risk (95% CI: 1.28-4.26, p=.000) of cognitive impairment. CONCLUSIONS: MCR syndrome increases the risk of cognitive impairment in Mexican older adults. Simple measurements such as gait evaluation in subjects with memory complaints could allow early identification of those at risk of developing cognitive impairment.


Assuntos
Disfunção Cognitiva/diagnóstico , Comportamentos Relacionados com a Saúde/fisiologia , Testes Neuropsicológicos/normas , Idoso , Envelhecimento , Disfunção Cognitiva/complicações , Progressão da Doença , Feminino , Seguimentos , Marcha , História do Século XXI , Humanos , Masculino , México , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Síndrome
2.
J Nutr Health Aging ; 21(2): 215-219, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28112779

RESUMO

OBJECTIVE: To determine the socio-demographic and health factors associated with a biomedical phenotype of successful aging (SA) among Mexican community-dwelling elderly. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of 935 older adults aged 70 or older participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. MEASUREMENTS: SA was operationalized in accordance with the phenotype proposed by Rowe and Kahn. Univariate and multivariate logistic regression analyses were carried out in order to identify the correlates of SA. RESULTS: The phenotype of SA was present in 10% of participants. Age (P < 0.001), illiteracy (P = 0.021), polypharmacy (P < 0.001), and physical pain (P < 0.001) were factors independently and inversely associated with the presence of the SA phenotype. The only variable positively associated with SA was good self-perceived health-status (P < 0.001). CONCLUSION: Although age is not modifiable, several other factors associated with SA are. If we are to promote SA, efforts should be made towards improving those modifiable factors negatively associated with its presence, such as pain or polypharmacy. Also, enhancing factors positively associated to it might play a role in improving wellbeing.


Assuntos
Envelhecimento , Países em Desenvolvimento , Nível de Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Vida Independente , Modelos Logísticos , Masculino , México , Análise Multivariada , Inquéritos Nutricionais , Polimedicação
3.
Neurologia ; 32(5): 309-315, 2017 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26971058

RESUMO

INTRODUCTION: Mixed dementia (DMix) refers to dementia resulting from Alzheimer disease in addition to cerebrovascular disease. The study objectives were to determine the clinical and imaging factors associated with Dmix and compare them to those associated with Alzheimer disease. MATERIAL AND METHODS: Cross-sectional study including 225 subjects aged 65 years and over from a memory clinic in a tertiary hospital in Mexico City. All patients underwent clinical, neuropsychological, and brain imaging studies. We included patients diagnosed with DMix or Alzheimer disease (AD). A multivariate analysis was used to determine factors associated with DMix. RESULTS: We studied 137 subjects diagnosed with Dmix. Compared to patients with AD, Dmix patients were older and more likely to present diabetes, hypertension, dyslipidaemia, and history of cerebrovascular disease (P<.05). The multivariate analysis showed that hypertension (OR 1.92, CI 1.62-28.82; P=.009), white matter disease (OR 3.61, CI 8.55-159.80; P<.001), and lacunar infarcts (OR 3.35, CI 1.97-412.34; P=.014) were associated with Dmix, whereas a history of successfully treated depression showed an inverse association (OR 0.11, CI 0.02-0-47; P=.004) CONCLUSIONS: DMix may be more frequent than AD. Risk factors such as advanced age and other potentially modifiable factors were associated with this type of dementia. Clinicians should understand and be able to define Dmix.


Assuntos
Doença de Alzheimer/complicações , Transtornos Cerebrovasculares/complicações , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/etiologia , Estudos Transversais , Demência Vascular , Feminino , Humanos , Masculino , México , Fatores de Risco
4.
J Frailty Aging ; 2(2): 68-76, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-27070661

RESUMO

BACKGROUND: "Frailty" has emerged as a condition associated with an increased risk of functional decline among the elderly, which may be differentiated from aging, disability, and co-morbidities. OBJECTIVE: The Mexican Study of Nutritional and Psychosocial Markers of Frailty among Community-Dwelling Elderly has emerged to help answer many questions about frailty among the older adults. This report presents the design of the study and baseline data of its participants. DESIGN: The "Coyoacan cohort" is a longitudinal observational study developed in Mexico City. PARTICIPANTS: A representative sample of 1,294 non-institutionalized men and women aged 70 years and older were randomly recruited to undergo a face-to-face interview and a comprehensive geriatric assessment (including clinical evaluations and blood samples) between 2008 and 2009. MEASUREMENTS: Data collected included socio-demographic and economic characteristics, medical history, oral health, drug use, cognitive function and mood, nutritional status, physical performance and functional status, physical activity, quality of life, social networks, and biological data. Frailty was defined as the presence of ≥3 of the following components: slowness, poor muscle strength, low physical activity, exhaustion and unintentional weight loss. RESULTS: A total of 1,124 participants completed the interview. The mean age was 79.5 ± 7.1 years, and 55.9% were female. Nine hundred and forty-five subjects completed the clinical evaluation and 743 blood samples were collected. The baseline prevalence of frailty was 14.1%. CONCLUSIONS: Understanding the medical, biological, and environmental factors that contribute to the phenomenon of frailty is the goal of the current research in the field.

5.
J Frailty Aging ; 1(3): 111-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-27093198

RESUMO

BACKGROUND: Frailty represents a major public health priority in Western countries. Specific social and cultural factors may influence the prevalence and predictive value for negative health-related events of this syndrome. OBJECTIVE: To determine the prevalence and predictive value of the phenotype of frailty among community-dwelling Mexican American older persons. DESIGN, SETTING AND PARTICIPANTS: Two-year longitudinal study of 5,644 men and women aged 60 years and older participating in the Mexican Health and Aging Study. MEASUREMENTS: The Frailty index used in the present study was a modified version of the operational definition proposed in the Cardiovascular Health Study (CHS). Frailty was defined by the presence of at least three of the four following criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. The main outcomes were incident disability and mortality. Chi-square, ANOVA and multiple logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest. RESULTS: The mean age of the study sample was 68.7 (SD 6.9) years. Thirty-seven percent of participants (n=2,102) met the definition of frailty. Frail subjects were significantly older, and more likely to be women than non-frail participants. They also presented lower education, more chronic diseases, lower income, and poorer self-reported health status. After adjusting for potential confounders, frailty was found to be a predictor of incident mobility disability (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.37-2.66), activities of daily living (ADL) disability (OR 9.33; 95%CI 3.37-25.82), and instrumental ADL (IADL) disability (OR 1.81, 95%CI 1.23-2.68). The risk of mortality among frail participants was almost three-fold higher than in non-frail ones. CONCLUSION: The prevalence of frailty is higher in this elderly population than what previously reported in other cohorts. The phenotype of frailty was confirmed to be a predictor for adverse health-related outcomes (including mobility, ADL, and IADL disability). Further studies in Latin American countries are needed to identify frailty and develop adapted interventions for the prevention of adverse outcomes in older persons.

6.
J Nutr Health Aging ; 15(8): 683-9, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21968865

RESUMO

OBJECTIVE: To determine the association of the five frailty criteria from the Cardiovascular Health Study, as well as cognitive impairment, with prevalent disability for the instrumental (IADL) and basic activities of daily living (ADL). DESIGN: Cross-sectional study of 475 community-dwelling subjects aged 70 and older, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty. MEASUREMENTS: Six probable frailty criteria were considered: weight loss, poor endurance, low physical activity, slowness, weakness, and cognitive impairment. The association of each component of frailty for IADL and ADL disability as main outcomes was determined constructing multivariate logistic regression analyses. Final models were adjusted by socio-demographic factors and the presence of the other five frailty components as covariates. RESULTS: Mean age of participants was 78.1 (SD=6.2). The unadjusted results showed that each of the components of frailty, except weight loss, was associated with both IADL and ADL disability. However, after adjustment, only low physical activity [Odds ratio (OR) =3.27; 95% CI=1.56 to 6.85] and cognitive impairment (OR=2.06; 95% CI=1.04 to 4.06) remain independently associated with IADL disability. Regarding ADL disability, only a lower physical activity (OR=7.72; 95% CI=1.28 to 46.46) was associated with this outcome, whereas cognitive impairment was marginally associated but was not statistically significant (OR=5.45; 95% CI=0.91 to 32.57). CONCLUSIONS: Cognitive impairment and low physical activity are the main contributing factors of frailty phenotype to disability. Better understanding the independent contribution of each frailty subdimension to the different adverse-health outcomes may help to provide a more adequate management of frail elderly.


Assuntos
Atividades Cotidianas , Transtornos Cognitivos , Pessoas com Deficiência , Idoso Fragilizado , Esforço Físico , Aptidão Física , Idoso , Idoso de 80 Anos ou mais , Cognição , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , México , Análise Multivariada , Debilidade Muscular , Resistência Física , Redução de Peso
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