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Seong H, Resnick B, Holmes S, Galik E, Breman RB, Fortinsky RH, Zhu S. Exploring Factors Associated With Resilience and Physical Activity in Older Men and Women Post-Hip Fracture. J Appl Gerontol 2024; 43:627-637. [PMID: 38105620 DOI: 10.1177/07334648231221640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
This study aimed to test a model of factors associated with resilience and physical activity post-hip fracture and compare model fit between men and women. We used data from the seventh Baltimore Hip Study that included 339 participants. Model testing indicated that health status (men: β = .237, p = .002; women: β = .265, p = <.001), depression (men: β = -.245, p = .001; women: β = -.241, p = <.001), and optimism (men: β = .320, p = <.001; women: β = .282, p = <.001) were associated with resilience in men and women, but resilience was only associated with physical activity in men (β = .203, p = .038) and not in women. Social interaction was related to physical activity only among women (β = .206, p = .044). This study provides support for the relationship between resilience and physical activity at least among men.
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Affiliation(s)
| | | | | | | | | | | | - Shijun Zhu
- University of Maryland, Baltimore, MD, USA
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Ferreira BH, de Aguiar RG, Santos EFDS, Cesar CLG, Goldbaum M, Monteiro CN. Physical activity among older adults with multimorbidity: Evidence from a population-based health survey. PLoS One 2024; 19:e0296460. [PMID: 38166094 PMCID: PMC10760873 DOI: 10.1371/journal.pone.0296460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/13/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION The promotion of physical activity has been recognized as an important component in the management and prevention of multimorbidity, a condition that is increasing prevalent worldwide, including in Brazil. However, there is a scarcity of studies exploring the disparity in physical activity levels between individuals with and without multimorbidity. Therefore, the study aimed to estimate the prevalence of multimorbidity and physical activity among older adults, as well as analyze the relationship of a sufficient level of physical activity and multimorbidity, while considering sociodemographic characteristics of residents in São Paulo, Brazil. MATERIALS AND METHODS Data from 1.019 participants aged 60 years or older (59.7% female; mean age 69.7±7.7) were collected from the Health Survey (ISA-Capital, 2015) conducted in the city of São Paulo, Brazil. We defined multimorbidity as the presence of two or more chronic conditions, and for physical activity, classified a sufficient level (≥150 min/week). Prevalence Ratios (PR) with 95% Confidence Intervals (95%CI) were estimated using univariate and multivariate Poisson regression to examine the relationship between multimorbidity and sufficient level of physical activity. RESULTS 67.7% of the participants lived with multimorbidity, while 30.1% had achieved a sufficient level of physical activity. There was a higher prevalence of sufficient level of physical activity among older adults with two (PR = 1.38; 95%CI 1.02-1.88) and four (PR = 1.37; 95%CI 1.00-1.87) chronic conditions. Older adults with multimorbidity who were 70 years or older (PR = 1.77; 95%IC 1.13-2.77), female (PR = 1.65; 95%CI 1.16-2.36), without a partner (PR = 1.43; 95%IC 1.03-1.99), and had a per capita income of 1 to 2.5 (PR = 1.83; 95%IC 1.00-3.33) were more likely to achieve a sufficient level of physical activity compared to their peers without multimorbidity. CONCLUSIONS The study highlights sociodemographic disparities in the sufficient level of physical activity among multimorbidity, suggesting the importance of considering these factors when planning public policies aimed at promoting physical activity.
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Affiliation(s)
- Bruno Holanda Ferreira
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Ricardo Goes de Aguiar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo (SP), Brazil
| | | | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
| | - Camila Nascimento Monteiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil
- Hospital Sírio-Libanês, São Paulo (SP), Brazil
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Poulsen VR, Fischer LK, Aadahl M, Mortensen OS, Skou ST, Jørgensen LB, Jepsen R, Møller A, Petersen TL, Brønd JC, Tang L, Korshøj M. The association between physical activity, low-grade inflammation, and labour market attachment among people with multimorbidity: A cross-sectional study from the Lolland-Falster Health Study, Denmark. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231195510. [PMID: 37621316 PMCID: PMC10447179 DOI: 10.1177/26335565231195510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
Aim Evidence suggests low-grade inflammation (LGI) to be associated with multimorbidity. Furthermore, there are links between inflammation markers, physical activity (PA), and labour market participation. The aims of this study were to examine the association between PA and LGI in people with multimorbidity and if this association was moderated by self-reported labour market attachment. Methods Cross-sectional data were collected in the Lolland-Falster Health Study (LOFUS) from 2016-2020. We included 1,106 participants with multimorbidity and valid accelerometer data. PA was measured as the average counts per minute (CPM) per day during wake time and split in time spent in moderate to vigorous intensity (MVPA) and light intensity (LPA). Degree of inflammation was determined by high sensitive C-reactive protein (hsCRP) level. Associations were investigated using multiple logistic regression analyses, stratified by labour market attachment. Results The odds of having LGI was higher with lower amount of daily LPA. The highest odds of LGI was observed for CPM < 200 per day (odds ratio (OR) 2.55; 95% confidence interval (CI) 1.46-4.43), MVPA < 15 minutes per day (OR 2.97; 95 % CI 1.56-5.62), and LPA < 90 (OR 2.89; 95 % CI 1.43-5.81) with the reference groups being CPM ≥ 400 per day, MVPA ≥ 30, and LPA ≥ 180 min per day, respectively. We could not preclude an interaction between LPA and labour market attachment (p = 0.109). Conclusion PA recommendations should be developed with attention to people with chronic diseases, who may experience barriers to reach PA at high intensities. People with no labour market attachment may benefit from primary and secondary prevention of multimorbidity.
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Affiliation(s)
- Vivian Rueskov Poulsen
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
| | - Linda Kjær Fischer
- Department of Strategy and Plan, Zealand University Hospital, Køge, Denmark
| | - Mette Aadahl
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
| | - Lars Bo Jørgensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Denmark
| | - Randi Jepsen
- Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Anne Møller
- Centre of Research and Education in General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Primary Health Care Research Unit, Region Zealand, Denmark
| | - Therese Lockenwitz Petersen
- Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
- The Department of Regional Health Research, University of Southern, Odense, Denmark
| | - Mette Korshøj
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
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Delpino FM, de Lima APM, da Silva BGC, Nunes BP, Caputo EL, Bielemann RM. Physical Activity and Multimorbidity Among Community-Dwelling Older Adults: A Systematic Review With Meta-Analysis. Am J Health Promot 2022; 36:1371-1385. [PMID: 35621359 DOI: 10.1177/08901171221104458] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study evaluated the relationship between physical activity (PA) and multimorbidity in community-dwelling older adults. DATA SOURCE A systematic review and meta-analysis in the following databases: Pubmed, Lilacs, Scielo, Web of Science, Scopus, and AgeLine. STUDY INCLUSION AND EXCLUSION CRITERIA It included observational studies investigating the association between physical activity and multimorbidity, with older adults, published until May 2021. Studies with institutionalized individuals or that assessed specific diseases were excluded. DATA EXTRACTION Two reviewers independently extracted the studies based on previous inclusion and exclusion criteria, started by selecting titles, followed by abstracts and full-text reading. DATA SYNTHESIS Meta-analysis results were reported as Odds Ratio (OR) with a 95% confidence interval using R language. The Newcastle Ottawa scale was used to assess the quality of the studies. RESULTS Fifteen studies were included in the systematic review, from which 12 reported an inverse association between physical activity and multimorbidity. In the meta-analysis, from over 77 000 older adults, there was an inverse association between physical activity and multimorbidity [OR: .81; 95% CI: .73-.89]. We found significant results only for men in the analysis by sex. CONCLUSIONS Low levels of physical activity were associated with a higher risk of multimorbidity in older adults. It is expected that public policies will be conducted aimed at the practice of physical activity among older adults.
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Affiliation(s)
- Felipe Mendes Delpino
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, 37902Federal University of Pelotas, Pelotas, Brazil
| | - Ana Paula Maciel de Lima
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, 37902Federal University of Pelotas, Pelotas, Brazil
| | | | - Bruno Pereira Nunes
- Postgraduate Program in Nursing, 37902Federal University of Pelotas, Pelotas, Brazil
| | - Eduardo Lucia Caputo
- Postgraduate Program in Physical Education, 37902Federal University of Pelotas, Pelotas, Brazil
| | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, 37902Federal University of Pelotas, Pelotas, Brazil
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Barboza LLS, Werneck AO, Araujo RHO, Porto LGG, Silva DR. Multimorbidity is associated with TV-viewing, but not with other types of screen-based behaviors in Brazilian adults. BMC Public Health 2022; 22:1991. [PMID: 36316727 PMCID: PMC9623956 DOI: 10.1186/s12889-022-14365-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background The presence of multimorbidity increases the risk of mortality, and identifying correlates of multimorbidity can direct interventions by targeting specific modifiable correlates. Here we aimed to investigate the association between two types of screen-based behaviors and multimorbidity. Methods We used data from 87,678 Brazilian adults from the National Health Survey (2019). Multimorbidity (presence of two or more chronic conditions among 12 possibilities), TV-viewing, and time on other types of screens (computer, tablet, or cell phone), were self-reported. Crude and adjusted binary and multinominal logistic regression models were performed stratified by sex, age group, and the number of chronic conditions. Results Considering adjusted values, 2 h/day as a reference, and reporting values in odds ratio (OR) and prevalence ratio (PR) with 95% confidence intervals (95%CI), multimorbidity presented associations with TV-viewing in general [from OR (95%CI) 1.10 (1.03–1.18) in 2 to < 3 h/d, to OR (95%CI) 1.57 (1.40–1.76) in ≥ 6 h/d], except in 2 to < 3 h/d time category for male and 35 to 49 years, and all time categories for 18 to 34 years. In addition, TV-viewing was associated with an increasing number of chronic conditions, all greater in ≥ 6 h/d [2 conditions - PR (95%CI) 1.24 (1.08–1.43); 3 conditions - PR (95%CI) 1.74 (1.45–2.08); 4 or more conditions - PR (95%CI) 2.29 (1.93–2.73)], except in 2 conditions on 2 to < 3 h/d. Other types of screen-based behaviors were only associated with multimorbidity among males [≥ 6 h/d: OR (95%CI) 1.22 (1.01–1.48)] and older individuals (65 years) in some time categories [3 to < 6 h/d: OR (95%CI) 1.98 (1.42–2.77) and ≥ 6 h/d: OR (95%CI) 1.73 (1.06–2.84)]. Conclusion Intervention strategies for reducing screen time in Brazilian adults should focus mainly on TV-viewing, which seems to be associated with more harmful conditions than time on other types of screen-based behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14365-5.
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Affiliation(s)
- Luciana L. S. Barboza
- grid.7632.00000 0001 2238 5157Study Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS), Postgraduate Program in Physical Education, University of Brasília (UnB), Brasília, DF Brazil ,grid.7632.00000 0001 2238 5157Postgraduate Program in Physical Education, University of Brasília, Campos Darcy Ribeiro, 70910-900 Brasília, Distrito Federal Brazil
| | - André O Werneck
- grid.11899.380000 0004 1937 0722Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, SP Brazil
| | - Raphael H O Araujo
- grid.411400.00000 0001 2193 3537Graduation Program in Health Sciences, Londrina State University (UEL), Londrina, PR Brazil
| | - Luiz G G Porto
- grid.7632.00000 0001 2238 5157Study Group in Physiology and Epidemiology of Exercise and Physical Activity (GEAFS), Postgraduate Program in Physical Education, University of Brasília (UnB), Brasília, DF Brazil
| | - Danilo R Silva
- grid.441837.d0000 0001 0765 9762Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile ,grid.15449.3d0000 0001 2200 2355 Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), 41013 Seville, Spain
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Jørgensen LB, Bricca A, Bernhardt A, Juhl CB, Tang LH, Mortensen SR, Eriksen JA, Walløe S, Skou ST. Objectively measured physical activity levels and adherence to physical activity guidelines in people with multimorbidity-A systematic review and meta-analysis. PLoS One 2022; 17:e0274846. [PMID: 36223336 PMCID: PMC9555650 DOI: 10.1371/journal.pone.0274846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To determine levels of objectively measured physical activity (PA) and the proportion of adults with multimorbidity that adheres to PA guidelines. Methods All studies, where PA was measured at baseline using an activity monitor in an adult (≥18 years) multimorbid (≥80% of the population had ≥2 chronic conditions) population. A systematic literature search was performed in Medline, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, opengrey.eu and google.com from inception up until 18th of January 2022. Risk of bias was assessed with a modified version of the Quality Assessment Tool for Quantitative Studies. A random-effects meta-analyses was performed to estimate daily minutes of sedentary behavior (SB), light PA (LPA), moderate PA (MPA), moderate to vigorous PA (MVPA) and steps. Proportions adhering to PA guidelines was narratively synthesized. Certainty of evidence was determined using The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Fifteen studies (2,172 participants) were included. The most frequent combination of conditions were type 2 diabetes and hypertension (six studies). Participants spent a daily average of 500.5 (95% CI: 407.1 to 593.9) minutes in SB, 325.6 (95% CI: 246.4 to 404.7 minutes in LPA and 32.7 (95% CI: 20.2 to 45.3) minutes in MVPA. The mean daily number of steps was 5,145 (95% CI: 4264 to 6026) for people in free-living conditions. The proportion adhering to PA guidelines ranged widely (7.4% to 43%). All studies were rated as at high risk of bias and the certainty of evidence was very low. Conclusions PA levels and adherence varied from low to above guideline recommended levels for adults with chronic conditions, depending on PA intensity. The very low certainty of evidence calls for high quality studies focusing on detailed descriptions of PA behavior in people with multimorbidity. PROSPERO registration number CRD42020172456.
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Affiliation(s)
- Lars Bo Jørgensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Alessio Bricca
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Anna Bernhardt
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Carsten B. Juhl
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Lars Hermann Tang
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- The Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Jonas Ahler Eriksen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Sisse Walløe
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
| | - Søren T. Skou
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Asenjo-Alarcón JA. Diagnóstico clínico integral de adultos mayores atendidos en Perú. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Los adultos mayores constituyen el grupo poblacional más vulnerable y el menos favorecido por los sistemas de salud, transitan por un proceso de involución progresiva que puede repercutir en su salud; por tanto, se torna relevante el diagnóstico clínico oportuno y adecuado para identificar eventuales alteraciones. Objetivo: Establecer el diagnóstico clínico integral según sexo y edad de adultos mayores atendidos a nivel nacional en el Perú. Materiales y métodos: Se realizó un estudio descriptivo, transversal y retrospectivo, durante marzo y abril del 2021, en 60698 adultos mayores atendidos en todos los departamentos del Perú. La valoración física, funcional, mental y social de los adultos mayores se realizó mediante la Historia Clínica de Atención Integral de Salud del Adulto Mayor y se interpretó con su guía técnica. Se describieron frecuencias absolutas, relativas, intervalos de confianza para proporciones al 95% y el chi cuadrado de homogeneidad. Resultados: El 49,4% de adultos mayores estaban enfermos, de los cuales el 50,8% fueron mujeres y el 47,4% varones, el 50,0% tenían de 60 a 69 años, el 50,6% de 70 a 79 años y el 46,1% de 80 a más años. Se encontraron diferencias estadísticamente significativas entre el diagnóstico clínico integral por sexo y edad (p = 0,000). Discusión: Independientemente del número de participantes en todos los contextos estudiados, al menos una enfermedad crónica coexiste medianamente en los adultos mayores, sin ser determinante el lugar donde viven, pues el proceso de envejecimiento solo puede ser distinto en su velocidad de progresión y en las condiciones en que se presenta. Conclusión: Los adultos mayores en su mayoría estaban enfermos, fueron mujeres y tenían de 70 a 79 años, las diferencias por sexo y edad en el diagnóstico clínico integral fueron significativas. Las intervenciones en etapas previas contribuirían de manera importante en un envejecimiento saludable. Como citar este artículo: Asenjo-Alarcón José Ander. Diagnóstico clínico integral de adultos mayores atendidos en Perú. Revista Cuidarte. 2022;13(2): e2485. http://dx.doi.org/10.15649/cuidarte.2485
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