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Perea-García M, Martori JC, Del Moral-Pairada M, Amblàs-Novellas J. [Geriatric syndromes in intermediate care resources: Screening, prevalence and inpatient mortality. Multicenter prospective study]. Rev Esp Geriatr Gerontol 2023; 58:134-140. [PMID: 37142459 DOI: 10.1016/j.regg.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To determine the prevalence of geriatric syndromes (GS) in the geriatric population of the different intermediate care resources, as well as its relationship with intrahospital mortality. MATERIAL AND METHODS A prospective observational descriptive study, carried out in intermediate care resources in the Vic area (Barcelona) between July 2018 and September 2019. All people aged ≥65 years and/or criteria of complex chronic patient and/or advanced chronic disease, who were assessed for the presence of GS using the trigger questions of the Frail VIG-Index (IF-VIG), administered at baseline, on admission, on discharge and 30 days after discharge. RESULTS Four hundred and forty-two participants were included, of which 55.4% were women, with a mean age of 83.48 years. There are significant differences (P<.05) between frailty, age and number of GS in relation to the intermediate care resource at the time of admission. There were significant differences in the prevalence of GS between the group of patients who died during the hospitalization (24.7% of the sample) in relation to the survivors: both in a situation baseline (malnutrition, dysphagia, delirium, loss of autonomy, pressure ulcers, and insomnia), as well as in the admission assessment (falls, malnutrition, dysphagia, cognitive impairment, delirium, loss of autonomy, and insomnia). CONCLUSIONS There is a close relationship between the prevalence of GS and in-hospital mortality in intermediate care resources. In the absence of more studies, the use of the IF-VIG as a screening checklist for GS could be useful for its detection.
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Affiliation(s)
- Miquel Perea-García
- Hospital de Sant Celoni, Sant Celoni, Barcelona, España; Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG), Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Barcelona, España.
| | - Joan Carles Martori
- Grupo de Investigación Data Analysis and Modeling, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Barcelona, España
| | - Marta Del Moral-Pairada
- Centro de Atención Primaria, Consorcio de Atención Primaria de Salud de Eixample (CAPSBE), Barcelona, España
| | - Jordi Amblàs-Novellas
- Grupo de Investigación en Cronicidad de la Cataluña Central (C3RG), Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Barcelona, España
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Camacho-Torregrosa S, Albert-Ros X, Aznar-Cardona J, Mollar-Talamantes M, Bordonaba-Mateos MA, Galán-Bernardino JV. [Frail-VIG index: Convergent and discriminatory validity with respect to Short Physical Performance Battery in general population]. Rev Esp Geriatr Gerontol 2023; 58:75-83. [PMID: 36842943 DOI: 10.1016/j.regg.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/21/2023] [Accepted: 01/26/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Studies of frailty in primary health care (PHC) using frailty indexes are scarce. Frail-VIG index assesses the level of frailty through a multidimensional approach. The main objective was to investigate the convergent and discriminative validity of the frail-VIG index with respect to Short Physical Performance Battery (SPPB) in general population ≥ 70 years. POPULATION, MATERIALS AND METHODS Descriptive cross-sectional study. We included 416 non-institutionalized patients aged 70 years or over from two lists of general practitioners in a semi-urban healthcare center. Main variables were: frail-VIG index and SPPB. RESULTS The value of the area under the ROC curve of frail-VIG index respect SPPB < 7 was 0.81 (95% CI: 0.76-0.86). Pearson's correlation coefficient was -0.59 (95% CI: -0.524 to -0.649). The mean of frail-VIG index in those classified as not frail by SPPB < 7 was 0.103 (95% CI: 0.094-0.112) and in the frail was 0.242 (95% CI: 0.215-0.269). We obtained significant differences in the mean and distribution of the SPPB according to the frail-VIG index categories. The frailty prevalence according to the frail-VIG index was 29.3% (95% CI: 25.2-33.9), initial 19%, intermediate 7.5% and advanced 2.9%. There were frailty people by frail-VIG index and not by SPPB < 7 the 10.4%; on the contrary the 9.6%, the mean of affected domains of frail-VIG index was 3.9 and 2.2, respectively. CONCLUSIONS The frail-VIG index presents adequate convergent and discriminative validity with respect to the SPPB that supports the use in PHC. There is a 20% of participants classified as frail in a discordant way, who presents a different profile.
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Affiliation(s)
- Susana Camacho-Torregrosa
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España; Grupo de Atención al Mayor de la Sociedad Valenciana de Medicina Familiar y Comunitaria, Valencia, España.
| | - Xavier Albert-Ros
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España; Grupo de Atención al Mayor de la Sociedad Valenciana de Medicina Familiar y Comunitaria, Valencia, España
| | - Javier Aznar-Cardona
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España
| | - María Mollar-Talamantes
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España
| | - María Alicia Bordonaba-Mateos
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España
| | - José Vicente Galán-Bernardino
- Medicina Familiar y Comunitaria, Centro de Salud de Moncada, Departamento Hospital Arnau de Vilanova-Llíria, Valencia, España
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Amblàs-Novellas J, Torné A, Oller R, Martori JC, Espaulella J, Romero-Ortuno R. Transitions between degrees of multidimensional frailty among older people admitted to intermediate care: a multicentre prospective study. BMC Geriatr 2022; 22:722. [PMID: 36050635 PMCID: PMC9438217 DOI: 10.1186/s12877-022-03378-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background Frailty is a dynamic condition that is clinically expected to change in older individuals during and around admission to an intermediate care (IC) facility. We aimed to characterize transitions between degrees of frailty before, during, and after admission to IC and assess the impact of these transitions on health outcomes. Methods Multicentre observational prospective study in IC facilities in Catalonia (North-east Spain). The analysis included all individuals aged ≥ 75 years (or younger with chronic complex or advanced diseases) admitted to an IC facility. The primary outcome was frailty, measured by the Frail-VIG index and categorized into four degrees: no frailty, and mild, moderate, and advanced frailty. The Frail-VIG index was measured at baseline (i.e., 30 days before IC admission) (Frail-VIG0), on IC admission (Frail-VIG1), at discharge (Frail-VIG2), and 30 days post-discharge (Frail-VIG3). Results The study included 483 patients with a mean (SD) age of 81.3 (10.2) years. At the time of admission, 27 (5.6%) had no frailty, and 116 (24%), 161 (33.3%), and 179 (37.1%) mild, moderate, and severe frailty, respectively. Most frailty transitions occurred within the 30 days following admission to IC, particularly among patients with moderate frailty on admission. Most patients maintained their frailty status after discharge. Overall, 135 (28%) patients died during IC stay. Frailty, measured either at baseline or admission, was significantly associated with mortality, although it showed a stronger contribution when measured on admission (HR 1.16; 95%CI 1.10–1.22; p < 0.001) compared to baseline (HR 1.10; 1.05–1.15; p < 0.001). When including frailty measurements at the two time points (i.e., baseline and IC admission) in a multivariate model, frailty measured on IC admission but not at baseline significantly contributed to explaining mortality during IC stay. Conclusions Frailty status varied before and during admission to IC. Of the serial frailty measures we collected, frailty on IC admission was the strongest predictor of mortality. Results from this observational study suggest that routine frailty measurement on IC admission could aid clinical management decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03378-9.
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Affiliation(s)
- Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), Rambla Hospital 52, 08500, Vic, Barcelona, Spain. .,Geriatric and Palliative Care Department, Hospital Universitari de La Santa Creu and Hospital Universitari de Vic. Vic, Barcelona, Spain. .,Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Catalonia, Spain.
| | - Anna Torné
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), Rambla Hospital 52, 08500, Vic, Barcelona, Spain.,Geriatric and Palliative Care Department, Hospital Universitari de La Santa Creu and Hospital Universitari de Vic. Vic, Barcelona, Spain
| | - Ramon Oller
- Data Analysis and Modelling Research Group, Department of Economics and Business, University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
| | - Joan Carles Martori
- Data Analysis and Modelling Research Group, Department of Economics and Business, University of Vic-Central University of Catalonia (UVIC-UCC), Barcelona, Spain
| | - Joan Espaulella
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), Rambla Hospital 52, 08500, Vic, Barcelona, Spain.,Geriatric and Palliative Care Department, Hospital Universitari de La Santa Creu and Hospital Universitari de Vic. Vic, Barcelona, Spain
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Cañón-Esquivel A, González-Vélez AE, Forjaz MJ. Factors associated with self-rated health status of older people with multimorbidity in Colombia: A cross-sectional study. Rev Esp Geriatr Gerontol 2021; 56:326-333. [PMID: 34629212 DOI: 10.1016/j.regg.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE In Colombia, older adults (60 years and older) are expected to represent 15.5% of the overall population by 2025. Consequently, the demand for social and healthcare services will increase, especially because of the numerous medical conditions associated with aging. The purpose of the present study was to determine the patient's self-rated health status of older adults with multimorbidity and its determining factors based on gender in an insurance company of the Colombian health system. METHODOLOGY A cross-sectional study was performed to analyze the sociodemographic and clinical characteristics of 438 patients older than 75 years as well as their self-rated health status (EQ-5D-3L questionnaire) during the first geriatric consultation of a comprehensive healthcare program. A multivariate linear regression analysis was performed to identify factors determining their self-rated health status. RESULTS Women had a worse self-rated health status than men [mean (standard deviation) EQ-5D index score: 0.77 (0.20) vs. 0.65 (0.18); p<0.001]. In all sample, factors independently associated with self-rated health status were self-perception of weakness and dependency. In men, additional factors related to EQ-5D index were low levels of physical activity, recurrent falls, fecal incontinence, and auditory and visual disorders. In women, other health-determining factors were decrease in walking speed, and a medical history of depression/anxiety. CONCLUSIONS Factors associated with the self-rated health status of older adults who were part of a comprehensive healthcare program in Colombia varied according to gender. This study will help in approaching health interventions in healthcare programs for older adults in a differentiated manner.
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Affiliation(s)
- Arlet Cañón-Esquivel
- Entidad Promotora de Salud Sanitas, Avenida Carrera 45 #109-20, Bogotá, Colombia
| | | | - Maria João Forjaz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III and REDISSEC, C/ Sinesio Delgado, 4, 28029 Madrid, Spain
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Zamora-Sánchez JJ, Zabaleta-Del-Olmo E, Gea-Caballero V, Julián-Rochina I, Pérez-Tortajada G, Amblàs-Novellas J. Correction to: Convergent and discriminative validity of the Frail-VIG index with the EQ-5D-3L in people cared for in primary health care. BMC Geriatr 2021; 21:424. [PMID: 34253182 PMCID: PMC8274050 DOI: 10.1186/s12877-021-02369-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Juan-José Zamora-Sánchez
- Gerència Territorial de Barcelona, Institut Català de la Salut, Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,School of Nursing, Universitat de Barcelona, Barcelona, Spain
| | - Edurne Zabaleta-Del-Olmo
- Gerència Territorial de Barcelona, Institut Català de la Salut, Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain. .,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. .,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. .,Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain.
| | - Vicente Gea-Caballero
- Nursing school "La Fe", Valencia, Spain.,GREIACC Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Iván Julián-Rochina
- Nursing Department, Universitat de Valencia, Valencia, Spain.,Fragilidad y Deterioro Cognitivo (FROG) Research Group, Universitat de Valencia, Valencia, Spain
| | - Gemma Pérez-Tortajada
- Primary care centre "Fondo", Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Santa Coloma de Gramenet, Spain
| | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic - University of Vic-Central University of Catalonia (UVIC-UCC), 08500, Vic, Spain
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Profiles of Frailty among Older People Users of a Home-Based Primary Care Service in an Urban Area of Barcelona (Spain): An Observational Study and Cluster Analysis. J Clin Med 2021; 10:jcm10102106. [PMID: 34068296 PMCID: PMC8153285 DOI: 10.3390/jcm10102106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The multidimensional assessment of frailty allows stratifying it into degrees; however, there is still heterogeneity in the characteristics of people in each stratum. The aim of this study was to identify frailty profiles of older people users of a home-based primary care service. Methods: We carried out an observational study from January 2018 to January 2021. Participants were all people cared for a home-based primary care service. We performed a cluster analysis by applying a k-means clustering technique. Cluster labeling was determined with the 22 variables of the Frail-VIG index, age, and sex. We computed multiple indexes to assess the optimal number of clusters, and this was selected based on a clinical assessment of the best options. Results: Four hundred and twelve participants were clustered into six profiles. Three of these profiles corresponded to a moderate frailty degree, two to a severe frailty degree and one to a mild frailty degree. In addition, almost 75% of the participants were clustered into three profiles which corresponded to mild and moderate degree of frailty. Conclusions: Different profiles were found within the same degree of frailty. Knowledge of these profiles can be useful in developing strategies tailored to these differentiated care needs.
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