Grip strength and functional recovery after hip fracture: An observational study in elderly population

Muscle strength is a common issue in fragility syndrome and sarcopenia, both of them involved in the pathogenesis of falls and fractures. The objective is to study the relationship between hand grip strength and functional recovery after hip fracture surgery. This prospective observational study included patients aged 65. years and older who were admitted to hospital for hip fracture surgery during a 12 month period. Functional status (Barthel Index), mental status (Cruz Roja Index), hand grip strength, 25/OH-Vitamin D plasmatic levels were evaluated at admission. Follow-up was performed 3. months after discharge to assess functional status and survival. Correlations between hand grip strength and the rest of variables were evaluated. Univariate and multivariate analyses were further applied. Mean age of subjects was 85.1. ±. 0.63 years. Out of 127 subjects, 103 were women and 24 were men. Hand grip strength was obtained in 85 patients (76.5%) and, values were between 3.3 and 24.8. kg and 81 patients (95.2%) had values below cut-point of sarcopenia considering European Working Group of Sarcopenia criteria. Hand grip strength at admission shows significant association to Barthel index at three months and functional recovery. It is also associated with age (P <. 0.001) (r = 0.81), sex (P = 0.001), cognitive status by Cruz Roja Index (P <. 0.001) and functional status measured at admission by Barthel Index (P <. 0.01) (r = -0.22). Multivariate analysis confirmed that variables were independently associated to grip strength. Hand grip strength measured at admission in Orthogeriatric Unit after hip fracture is directly related to functional recovery in elderly patients.

Sex-related differences in centenarians and their hearts

Sociedad Española de Cardiología. Proyecto de Registro Clínico de la Sección de Cardiología Clínica 2013

Hospital without dyspnea: Rationale and design of a multidisciplinary intervention

Dyspnea is a common and disabling symptom of respiratory and heart diseases, which is growing in incidence. During hospital admission, breathlessness is under-diagnosed and under-treated, although there are treatments available for controlling the symptom. We have developed a tailored implementation strategy directed to medical staff to promote the application of these pharmacological and non-pharmacological tools in dealing with dyspnea. The primary aim is to decrease the rate of patients that do not receive an adequate relief of dyspnea. This is a four-stage quasi-experimental study. The intervention consists in two teaching talks that will be taught in Cardiology and Respiratory Medicine Departments. The contents will be prepared by Palliative Care specialists, based on available tools for management of dyspnea and patients' needs. A cross-sectional study of dyspnea in hospitalized patients will be performed before and after the intervention to ascertain an improvement in dyspnea intensity due to changes in medical practices. The last phase consists in the creation of consensus protocols for dyspnea management based in our experience. The results of this study are expected to be of great value and may change clinical practice in the near future and promote a changing for the better of dyspnea care.

Edad y deseos de reanimación cardiopulmonar en pacientes cardiológicos

SIN FINANCIACIÓN

Cardiopatía isquémica crónica del anciano. Documento de consenso. Sociedades Españolas de Cardiología, Medicina Interna, Atención Primaria y Geriatría

SIN FINANCIACIÓN

Cardiopatía isquémica crónica en el anciano

Este artículo pretende tener en cuenta las peculiaridades y características específicas de los pacientes ancianos con cardiopatía isquémica crónica desde una perspectiva multidisciplinar, con la participación de la Sociedad Española de Cardiología (secciones de Cardiología Geriátrica y Cardiopatía Isquémica/Cuidados Agudos Cardiovasculares), la Sociedad Española de Medicina Interna, la Sociedad Española de Médicos de Atención Primaria y la Sociedad Española de Geriatría y Gerontología. En este documento de consenso se detalla cómo el abordaje de estos enfermos de edad avanzada exige una valoración integral de la comorbilidad, la fragilidad, el estado funcional, la polifarmacia y las interacciones medicamentosas. Concluimos que en la mayoría de los pacientes el tratamiento médico es la mejor opción y que, a la hora de programarlo, se deben tener en cuenta los factores anteriores y las alteraciones biológicas asociadas al envejecimiento.

End-of-life care in a cardiology department: have we improved?

nd-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate (DNR) order protocol. Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet (Group A), a conventional DNR order (Group B) or the absence of any DNR order (Group C). The number of deaths was similar in both periods (n = 198 vs. n = 197). The rate of patients dying with a DNR order increased significantly (57.1% vs. 68.5%; P = 0.02). Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission (vs. 2.6% in the first period; P < 0.001). All patients in Group A with an implantable cardioverter defibrillator (ICD) had shock therapies deactivated (vs. 25.0% in the first period; P = 0.02). The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.

Rapamycin reverses age-related increases in mitochondrial ROS production at complex I, oxidative stress, accumulation of mtDNA fragments inside nuclear DNA, and lipofuscin level, and increases autophagy, in the liver of middle-aged mice

Rapamycin consistently increases longevity in mice although the mechanism of action of this drug is unknown. In the present investigation we studied the effect of rapamycin on mitochondrial oxidative stress at the same dose that is known to increase longevity in mice (14 mg of rapamycin/kg of diet). Middle aged mice (16 months old) showed significant age-related increases in mitochondrial ROS production at complex I, accumulation of mtDNA fragments inside nuclear DNA, mitochondrial protein lipoxidation, and lipofuscin accumulation compared to young animals (4 months old) in the liver. After 7 weeks of dietary treatment all those increases were totally or partially (lipofuscin) abolished by rapamycin, middle aged rapamycin-treated animals showing similar levels in those parameters to young animals. The decrease in mitochondrial ROS production was due to qualitative instead of quantitative changes in complex I. The decrease in mitochondrial protein lipoxidation was not due to decreases in the amount of highly oxidizable unsaturated fatty acids. Rapamycin also decreased the amount of RAPTOR (of mTOR complex) and increased the amounts of the PGC1-α and ATG13 proteins. The results are consistent with the possibility that rapamycin increases longevity in mice at least in part by lowering mitochondrial ROS production and increasing autophagy, decreasing the derived final forms of damage accumulated with age which are responsible for increased longevity. The decrease in lipofuscin accumulation induced by rapamycin adds to previous information suggesting that the increase in longevity induced by this drug can be due to a decrease in the rate of aging. © 2016 Elsevier Inc.

Multivariate analysis of lifestyle, constitutive and body composition factors influencing bone health in community-dwelling older adults from Madeira, Portugal

info:eu-repo/semantics/publishedVersion

Estereotipos sobre el envejecimiento según el periodo del desarrollo y el género

Teniendo en cuenta el drástico aumento en Colombia y el mundo de la población adulta mayor la pirámide poblacional se ha invertido. Lo que ha generado que cada vez haya más adultos mayores y la esperanza de vida sea mayor. Motivo por el cual surge la importancia de conocer diversos aspectos del envejecimiento, entre ellos los estereotipos. Adicionalmente hay muy poca investigación relacionada con los estereotipos sobre el envejecimiento según el género y el periodo de desarrollo. Levy (2009) encontró que son los jóvenes quienes tienen más estereotipos negativos sobre el envejecimiento pues estos sienten que la vejez está muy lejos de su realidad actual y no es en una amenaza personal. Por otro lado Bodner, Bergman y Cohen (2012), encontraron que son los hombres quienes tienen más estereotipos negativos sobre el envejecimiento. La presente investigación tuvo como objetivo describir el efecto del periodo del desarrollo y el género en los estereotipos sobre el envejecimiento en 860 adultos colombianos. Se midió la variable de estereotipos sobre el envejecimiento a través del cuestionario de Ramírez y Palacios (2015) y el periodo del desarrollo y el género a través de un cuestionario de datos sociodemograficos. Contrario a lo esperado, los resultados mostraron que no existe relación entre los estereotipos negativos con el género, el periodo del desarrollo, ni en la interacción de estos. En cambio, se encontraron diferencias entre los estereotipos positivos el género y el periodo de desarrollo. Se considera importante continuar realizando investigaciones relacionadas con esta temática pues cada vez son más los adultos mayores y la manera en que nos relacionemos con ellos, va a determinar un mejor proceso de envejecimiento para ellos.

Impact on hip fracture mortality after the establishment of an orthogeriatric care program in a colombian hospital

El objetivo del estudio es evaluar la mortalidad a un año en pacientes con fractura de cadera, mayores de 65 años tratados en un programa establecido de orto-geriatría. 298 se trataron de acuerdo al protocolo de orto-geriatría, se calculo la mortalidad a un año, se establecieron los predictores de mortalidad orto-geriátrico. La sobrevida anual se incremento de 80% a 89% (p = .039) durante los cuatro años de seguimiento del programa y disminuyo el riesgo de mortalidad anual postoperatorio (Hazard Ratio = 0.54, p = .049). La enfermedad cardiaca y la edad maor a 85 años fueron predictores positivos para mortalidad.

Relación entre atrofia cortical difusa y desempeño cognitivo : estudio en población mayor de 60 años en un hospital universitario en la ciudad de Bogotá

El presente trabajo tuvo como objetivo evaluar la existencia de la relación entre la atrofia cortical difusa objetivada por neuroimagenes cerebrales y desempeños cognitivos determinados mediante la aplicación de pruebas neuropsicológicas que evalúan memoria de trabajo, razonamiento simbólico verbal y memoria anterógrada declarativa. Participaron 114 sujetos reclutados en el Hospital Universitario Mayor Méderi de la ciudad de Bogotá mediante muestreo de conveniencia. Los resultados arrojaron diferencias significativas entre los dos grupos (pacientes con diagnóstico de atrofia cortical difusa y pacientes con neuroimagenes interpretadas como dentro de los límites normales) en todas las pruebas neuropsicológicas aplicadas. Respecto a las variables demográficas se pudo observar que el grado de escolaridad contribuye como factor neuroprotector de un posible deterioro cognitivo. Tales hallazgos son importantes para determinar protocoles tempranos de detección de posible instalación de enfermedades neurodegenerativas primarias.