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Domínguez-Gómez M, Mora-Simón S, Rodríguez-Sánchez E. [Mortality associated with neurocognitive disorder and dependence in people over 55 years of age. Systematic review]. Rev Esp Geriatr Gerontol 2024; 59:101411. [PMID: 37820397 DOI: 10.1016/j.regg.2023.101411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION The increasing aging of the population brings with it an increase in the incidence of neurocognitive disorder (NCD) as well as various situations that generate dependence. OBJECTIVE To analyze by means of a systematic review the relationship between NCD and dependence with the risk of mortality in the elderly. METHODS A bibliographic search of longitudinal studies published in Pubmed and Scopus addressing the relationship between NCI, dependence for basic activities of daily living (ADL) and mortality published between 1995 and 2021 was performed. Of the 1040 articles found, 10 studies were selected. RESULTS It was observed that cohorts of elderly people with NCI presented mortality risk associated with ABVD impairment (Barthel test) and Mini-Mental State Examination scores following a significant linear trend. Other factors associated with mortality risk were low levels of education, living alone, and frailty. CONCLUSIONS The results underline the importance of performing assessments of cognitive and functional status using validated scales, since both areas are associated with mortality. The link between the three terms used in the search for this work is clear, but it is noteworthy that there are few longitudinal studies that analyze them together. The assessment of dependence and cognitive function in older adults should be considered in both research and clinical practice as it would provide information on their possible relationship with mortality.
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Affiliation(s)
- Manuel Domínguez-Gómez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016)
| | - Sara Mora-Simón
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016); Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Universidad de Salamanca, Salamanca, España
| | - Emiliano Rodríguez-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, España; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS) (RD21/0016); Departamento de Medicina, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.
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Minobes-Molina E, Pamies-Tejedor S, Roncal-Belzunce V, Escalada San Adrián G, Atarés Rodríguez L, García-Navarro JA. Multimodal home care intervention for dependent older people "Live better at home": Protocol of a randomized clinical trial. Rev Esp Geriatr Gerontol 2023; 58:101383. [PMID: 37453249 DOI: 10.1016/j.regg.2023.101383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/25/2023] [Accepted: 06/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The intensity of the home care interventions for dependent older people offered in Spain may not be sufficient to help keep older people living at home, being the institutionalization in a nursing home (NH) an unavoidable consequence. OBJECTIVE To evaluate the effect of intensification in home care interventions on users with grade II or III dependency, as well as training for their informal caregivers in order to delay or avoid their institutionalization in a NH. METHODS A randomized clinical trial with two parallel arms and blinded assessment will be conducted at the community level in two municipalities in Catalonia (Spain). The study will include those older people (aged 65 and over) living in the community, with degree II or III of dependency, users of the public home care unwilling to be institutionalized and with a main informal caregiver in charge, who will also participate in the study. The assessments will be performed monthly up to 15 months, when the intervention will be finished. The main outcome will be the time until the willingness for admission to a NH. Secondary variables will be composed of sociodemographic, health, psychosocial, resource use, and follow-up variables. A multivariate Cox regression model will be carried out to estimate the effectiveness of the intervention. DISCUSSION A multimodal home care intervention could improve the health and psychosocial status of dependent people and their informal caregivers and facilitate their permanence at home. TRIAL REGISTRATION NCT05567965.
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Affiliation(s)
- Eduard Minobes-Molina
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain; Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M(3)O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, 08500 Vic, Spain
| | - Sandra Pamies-Tejedor
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain.
| | - Victoria Roncal-Belzunce
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain
| | | | - Laura Atarés Rodríguez
- Spanish Society of Geriatrics and Gerontology, C. Príncipe de Vergara, 57-59, 28006 Madrid, Spain
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Jiménez García-Tizón S, Parra Ortiz MC, Navarro Prados AB, Muro Pérez-Aradros C, Meléndez JC. [Guilt and well-being in institutionalized family caregivers of dependent elderly people]. Rev Esp Geriatr Gerontol 2023:S0211-139X(23)00029-X. [PMID: 36922298 DOI: 10.1016/j.regg.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION AND OBJECTIVE The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons. MATERIALS AND METHODS Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed. RESULTS Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R2adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461). CONCLUSIONS Paying attention to family caregivers' feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization.
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Ripoll Perelló J, Barrés Fernández PC, Pick Martín J. [Study of correlation between different scales that measure smoking dependence]. Aten Primaria 2023; 55:102581. [PMID: 36796179 PMCID: PMC9958443 DOI: 10.1016/j.aprim.2023.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVE To analyze the correlation between the degrees of smoking dependence, measured with the Fagerström Test Nicotine Dependence (FTND), Glover-Nilsson Smoking Behavioral Dependence (GN-SBQ) and a measure of self-perceived-dependence (SPD). DESIGN Cross-sectional descriptive observational study. SITE: Urban primary health-care center. PARTICIPANTS Men and women between 18 and 65 years old, daily smokers, selected by non-random consecutive sampling. INTERVENTIONS Self-administration of various questionnaires though an electronic device. MAIN MEASUREMENTS Age, sex and nicotine dependence assessed by: FTND, GN-SBQ and SPD. Statistical analysis, with SPSS 15.0: descriptive statistics, Pearson correlation analysis and conformity analysis. RESULTS Two hundred fourteen smokers were included, 54.7% were women. Median age 52 years (range: 27-65). Depending on the test used, different results of the high/very high degree of dependence were found: FTND 17.3%, GN-SBQ 15.4% and SPD 69.6%. A moderate magnitude (r≈0.5) correlation between the 3 test was found. When assessing concordance, comparing the FTND with SPD, 70.6% of smokers didn't coincide in the severity of dependence, reporting a milder degree of dependence with the FTND than with SPD. Comparing GN-SBQ versus FTND, showed conformity in 44.4% of patients while in 40.7%, the FTND underestimated the severity of dependence. Likewise, when comparing SPD with the GN-SBQ, in the 64% GN-SBQ underestimates, while in 34.1% smokers conformity was demonstrated. CONCLUSIONS The number of patients who consider their SPD to be high/very high was four times higher compared to the GN-SBQ or the FNTD; the latter, being the most demanding, categorizing patients with very high dependence. Requiring a FTND score greater than 7 to prescribe drugs for smoking cessation may exclude subsidiary patients from receiving treatment.
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Affiliation(s)
- Jazmin Ripoll Perelló
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España; Universidad de Valencia, Valencia, España.
| | - Paula C Barrés Fernández
- Centro de Salud Fuente de San Luis, UDMAFYC Valencia, Hospital Universitario Doctor Peset, Valencia, España
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Sicras-Mainar A, Rejas-Gutierrez J, Vargas-Negrín F, Tornero-Tornero JC, Sicras-Navarro A, Lizarraga I. Disease burden and costs for patients with hip and knee osteoarthritis and chronic moderate-to-severe refractory pain on treatment with strong opioids in Spain. Reumatol Clin (Engl Ed) 2023; 19:90-98. [PMID: 36739122 DOI: 10.1016/j.reumae.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/07/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND OBJECTIVES To determine the disease burden and costs in patients with hip or knee OA and chronic moderate-to-severe refractory pain, receiving strong opioids in Spain. MATERIALS AND METHODS This was a 36-month longitudinal secondary analysis of the real-word OPIOIDS study. Patients aged ≥18 years with hip or knee OA and chronic moderate-to-severe refractory pain receiving strong opioids were considered. The disease burden included analgesia assessments (NRS scale), cognitive functioning (MMSE scale), basic activities of daily living (Barthel index), and comorbidities (severity and frequency). Costs due to the use of healthcare resources and productivity loss were estimated. RESULTS 2832 patients were analyzed; age was 72.0 years (SD=14.3), 76.8% were women. Patients had mainly been treated with fentanyl (n=979; 37.6%), tapentadol (n=625; 24.0%), oxycodone (n=572; 22.0%), and buprenorphine (n=425; 16.3%). Pain intensity decreased by 1 point (13.7%), with a 2.6-point decline in the cognitive scale (14.3%, with a 5.3%-increase in patients with cognitive deficit) over a mean treatment period of 384.6 days (SD: 378.8). Barthel scores decreased significantly yielding to a slightly increase in proportion of patients with severe-to-total dependency; 1.2%-2.9%. In the first year of treatment, average healthcare costs were €2013/patient, whereas the average productivity loss cost was €12,227/working-active patient. DISCUSSION AND CONCLUSIONS Strong opioids resulted in high healthcare costs with a limited reduction in pain, an increase in cognitive deficit, and a slight increase of patients with severe to total dependency over 36 months of treatment.
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Fernández-Espejo E, Núñez-Domínguez L. Endocannabinoid-mediated synaptic plasticity and substance use disorders. Neurologia 2022; 37:459-465. [PMID: 30857785 DOI: 10.1016/j.nrl.2018.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 01/15/2023] Open
Abstract
Drugs impact brain reward circuits, causing dependence and addiction, in a condition currently described as substance use disorders. Mechanisms of synaptic plasticity in these circuits are crucial in the development of addictive behaviour, and endocannabinoids, particularly anandamide and 2-arachidonyl-glycerol, participate in normal neuroplasticity. Substance use disorders are known to be associated with disruption of endocannabinoid-mediated synaptic plasticity, among other phenomena. Endocannabinoids mediate neuroplasticity in the short and the long term. In the short term, we may stress «inhibitory» phenomena, such as depolarisation-induced suppression of inhibition and depolarisation-induced suppression of excitation, and such «disinhibitory» phenomena as long-lasting disinhibition of neuronal activity, particularly in the striatum, and suppression of hippocampal GABA release. Drugs of abuse can also disrupt normal endocannabinoid-mediated long-term potentiation and long-term depression. Endocannabinoids are also involved in the development of drug-induced hypofrontality and sensitisation. In summary, substance abuse causes a disruption in the synaptic plasticity of the brain circuits involved in addiction, with the alteration of normal endocannabinoid activity playing a prominent role. This facilitates abnormal changes in the brain and the development of the addictive behaviours that characterise substance use disorders.
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Affiliation(s)
- E Fernández-Espejo
- Departamento de Fisiología Médica y Biofísica, Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
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Suller Marti A, Bellosta Diago E, Vinueza Buitron P, Velázquez Benito A, Santos Lasaosa S, Mauri Llerda JÁ. Epilepsy in elderly patients: does age of onset make a difference? Neurologia (Engl Ed) 2022; 37:171-177. [PMID: 35465910 DOI: 10.1016/j.nrleng.2019.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/03/2019] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Epilepsy is most frequent in children and elderly people. Today's population is ageing and epilepsy prevalence is increasing. The type of epilepsy and its management change with age. METHODS We performed a retrospective, observational study comparing patients aged ≥ 65 years with epilepsy diagnosed before and after the age of 65, and describing epilepsy characteristics and comorbidities in each group. RESULTS The sample included 123 patients, of whom 61 were diagnosed at < 65 years of age (group A), 62 at ≥ 65 of age (group B). Sex distribution was similar in both groups, with 39 men (62.9%) in group A and 37 (60.7%) in group B. Mean age was 69.97 ± 5.6 years in group A and 77.29 ± 6.73 in group B. The most common aetiology was cryptogenic in group A (44.3%, n = 27) and vascular in group B (74.2%, n = 46). History of stroke was present in 12 patients from group A (19.7%) and 32 (51.6%) in group B. Antiepileptic drugs were prescribed at lower doses in group A. Statistically significant differences were found between groups for history of ischaemic stroke, cognitive impairment, psychiatric disorders, and diabetes mellitus; degree of dependence; and number of antiepileptic drugs. CONCLUSION Age of onset ≥ 65 years is closely related to cardiovascular risk factors; these patients require fewer antiepileptic drugs and respond to lower doses. Some cases initially present as status epilepticus.
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Affiliation(s)
- A Suller Marti
- Programa de Epilepsia, Departamento de Ciencias Neurológicas, Schulich School of Medicine, Western University, London, Ontario, Canada.
| | - E Bellosta Diago
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - P Vinueza Buitron
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Velázquez Benito
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - S Santos Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - J Á Mauri Llerda
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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Suller Marti A, Bellosta Diago E, Vinueza Buitron P, Velázquez Benito A, Santos Lasaosa S, Mauri Llerda JÁ. Epilepsy in elderly patients: does age of onset make a difference? Neurologia 2022; 37:171-177. [PMID: 31103311 DOI: 10.1016/j.nrl.2019.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/12/2019] [Accepted: 03/03/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Epilepsy is most frequent in children and elderly people. Today's population is ageing and epilepsy prevalence is increasing. The type of epilepsy and its management change with age. METHODS We performed a retrospective, observational study comparing patients aged ≥ 65 years with epilepsy diagnosed before and after the age of 65, and describing epilepsy characteristics and comorbidities in each group. RESULTS The sample included 123 patients, of whom 61 were diagnosed at <65 years of age (group A), 62 at ≥ 65 of age (group B). Sex distribution was similar in both groups, with 39 men (62.9%) in group A and 37 (60.7%) in group B. Mean age was 69.97±5.6 years in group A and 77.29±6.73 in group B. The most common aetiology was unknown in group A (44.3%, n=27) and vascular in group B (74.2%, n=46). History of stroke was present in 12 patients from group A (19.7%) and 32 (51.6%) in group B. Antiepileptic drugs were prescribed at lower doses in group A. Statistically significant differences were found between groups for history of ischaemic stroke, cognitive impairment, psychiatric disorders, and diabetes mellitus; degree of dependence; and number of antiepileptic drugs. CONCLUSION Age of onset ≥ 65 years is closely related to cardiovascular risk factors; these patients require fewer antiepileptic drugs and respond to lower doses. Some cases initially present as status epilepticus.
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Affiliation(s)
- A Suller Marti
- Programa de Epilepsia, Departamento de Ciencias Neurológicas, Schulich School of Medicine, Western University, London, Ontario, Canadá.
| | - E Bellosta Diago
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - P Vinueza Buitron
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - A Velázquez Benito
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - S Santos Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Á Mauri Llerda
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Carvacho R, Carrasco M, Lorca MBF, Miranda-Castillo C. Met and unmet needs of dependent older people according to the Camberwell Assessment of Need for the Elderly (CANE): A scoping review. Rev Esp Geriatr Gerontol 2021; 56:225-235. [PMID: 33888307 DOI: 10.1016/j.regg.2021.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/24/2022]
Abstract
In order to address the complexity of needs of dependent older people, multidimensional and person-centered needs assessment is required. The objective of this review is to describe met and unmet needs of dependent older people, living in the community or in institutions, and the factors associated with those needs. Selection criteria included papers about need asessment which employed the Camberwell Assesment of Need for the Elderly (CANE). A search through MEDLINE, SCOPUS, WOS and CINHAL databases was carried out. Twenty-one articles were finally included. Unmet needs were found more frequently in psychosocial areas (mainly in "company", "daytime activities" and "psychological distress") and in institutionalized population. In addition, unmet needs were often associated with depressive symptoms, dependency, and caregiver burden. Discrepancies between self-reported needs and needs perceived by formal and informal caregivers were identified. It is important that professionals and caregivers try to make visible the perspective of older people and their psychological and social needs, particularly when the person is dependent, depressed or cognitively impaired.
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Affiliation(s)
- Raffaela Carvacho
- Pontificia Universidad Católica de Chile, School of Psychology, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile
| | - Marcela Carrasco
- Pontificia Universidad Católica de Chile, Faculty of Medicine, Santiago, Chile; UC Center for Studies in Age and Ageing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Beatriz Fernández Lorca
- Pontificia Universidad Católica de Chile, Institute of Sociology, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile; UC Center for Studies in Age and Ageing, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudia Miranda-Castillo
- Universidad Andres Bello, Faculty of Nursing, Santiago, Chile; Millennium Institute for Caregiving Research, Santiago, Chile; Millennium Institute for Research in Depression and Personality, Santiago, Chile.
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Yelincic A, Cárcamo RA. [Informal unpaid primary caregivers: Who takes care of disabled children, adults and seniors?]. Rehabilitacion (Madr) 2021; 55:190-198. [PMID: 33865614 DOI: 10.1016/j.rh.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/09/2020] [Accepted: 03/03/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study is to characterize informal unpaid primary caregivers of disabled people in a state of dependency regarding the age group they belong to. MATERIAL AND METHODS This was a quantitative, descriptive, correlational, no experimental and comparison group study. The sample consisted of 936 informal caregivers who work in the Region of Magallanes and Chilean Antarctica and whose data was collected from the database of the Cruz del Sur Physical Rehabilitation Center. RESULTS The main results show that disabled children are primarily taken care by their mothers; unlike adults and older adults that are mainly cared by their couples. Children caregivers are noticeably younger than adult and older adult caregivers. Likewise, adult caregivers are younger than older adult caregivers. With regard to the education level, children caregivers have a significantly higher education level than adult's and older adult's, with no meaningful difference between the 2latest groups. Additionally, children caregivers are mostly women, whereas the presence of male caregivers increases in the adult and older adults group. CONCLUSIONS Thus, the study concludes it is necessary to have differentiated psychosocial care mechanisms, since there are differences between caregivers depending on the age group they take care of.
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Affiliation(s)
- A Yelincic
- Corporación de Rehabilitación Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - R A Cárcamo
- Departamento de Psicología, Universidad de Magallanes, Punta Arenas, Chile.
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Rodríguez-González AM, Rodríguez-Míguez E. [Measurement of dependence based on the care time and the dependency assessment scale]. Rev Esp Geriatr Gerontol 2020; 56:35-40. [PMID: 33081980 DOI: 10.1016/j.regg.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/16/2020] [Accepted: 06/17/2020] [Indexed: 11/17/2022]
Abstract
AIMS To assign care time to the activities collected in the Dependency Assessment Scale (BVD) and to analyse the relationship between care time and the score received on the BVD. METHODS A cross-sectional observational study of 148 dependent persons was carried out. Socioeconomic and clinical data, the BVD, the 6-dimensional dependency indicator (DEP-6D), as well as data from a diary with the time of care received, were collected. The median time needed to carry out the activities included in the BVD was estimated from the diary. Following the BVD methodology, those who had their mental functions affected were separated. Each person was assigned two scores, one based on BVD and the other based on the time that the caregivers spent to care for them. The correlation between the two was estimated, and a regression was performed to identify the main explanatory factors for the disparity between the two indicators. RESULTS BVD and hours of care show a moderate positive correlation. The mental impairment of the dependent person increased the time of care in most activities. The regression analysis suggests that while mental impairment is the main explanatory factor of obtaining a higher assessment with care time than with BVD, being bedridden is the main predictor of having a higher sore with the BVD. CONCLUSIONS The construct that underlies BVD is moderately related to care time. Future research must contrast the robustness of these results and address whether the normative criteria that underlie the BVD is aligned with the weights that characterise it.
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Affiliation(s)
- Ana María Rodríguez-González
- Universidad de Vigo. Facultad de Ciencias de Educación y del Deporte, Pontevedra, España; Servicio Cántabro de Salud. Atención Primaria, Puente San Miguel, España; Fundación Biomédica Galicia Sur, Vigo, España.
| | - Eva Rodríguez-Míguez
- Fundación Biomédica Galicia Sur, Vigo, España; Departamento de Economía Aplicada. Universidad de Vigo. Facultad de Ciencias Económicas y Empresariales, Vigo, España; ECOBAS-GRiEE. Facultad de Ciencias Económicas y Empresariales, Vigo, España
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Huesa Andrade M, Calvo-Gallego JL, Pedregal González MÁ, Bohórquez Colombo P. [Differences between institutionalized patients and those included in a home care program in Seville]. Aten Primaria 2020; 52:488-495. [PMID: 32081457 PMCID: PMC7393548 DOI: 10.1016/j.aprim.2019.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022] Open
Abstract
Objetivo Conocer las características y las diferencias clínicas entre pacientes institucionalizados y los de programas de atención domiciliaria. Diseño Estudio observacional descriptivo transversal multicéntrico. Emplazamiento Sevilla, 2016. Participantes Un total de 1.857 pacientes ancianos (1.441 institucionalizados y 416 en domicilio). Mediciones Las variables estudiadas fueron: sexo, edad, estado civil, apoyo familiar, patologías, criterios de pluripatología y fármacos. Se valoraron el estado funcional y el cognitivo mediante las escalas de Barthel, Lawton-Brody y Pfeiffer. Resultados Un 71,40% fueron mujeres. Estadísticamente el hecho de estar institucionalizados o vivir en el domicilio se relaciona con las siguientes patologías y categorías: esquizofrenia (p < 0,001), HTA (p = 0,012), DM (p = 0,001), FA (p< 0,001) y neoplasias (p = 0, 012), A1 (p = 0,012), A2 (p < 0,001), B1 (p < 0,001), B2 (p = 0,002), C (p < 0,001), E1 (p < 0,001), E3 (p = 0,01), F2 (p < 0,01), G2 (p = 0,024) y H (p = 0,005). El promedio del índice de Barthel de la muestra fue de 49,1 ± 34,45 (IC 95%: 47,49-50,7), el de Lawton-Brody en domicilio fue de 2,33 ± 2,49 y en institucionalizados, de 1,59 ± 2,12. La media de la escala de Pfeiffer fue de 4,93 ± 3,53. Conclusiones Se asocia con la institucionalización el deterioro cognitivo, consecuencia de posibles patologías neurológicas (categoría E3) y psiquiátricas. Por el contrario, no se asocia con la comorbilidad del paciente, puesto que es muy elevada en pacientes en situación de atención domiciliaria con mejores estados de independencia funcional y cognitivo.
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Affiliation(s)
| | | | - Miguel Ángel Pedregal González
- Medicina Familiar y Comunitaria, Unidad Docente Medicina Familiar y Comunitaria de Huelva, Distrito Sanitario Huelva-Costa, Huelva, España
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Rodríguez-González AM, Rodríguez-Míguez E. [Need and use of assistive devices and architectural facilitators in a dependent population]. Aten Primaria 2020; 52:770-7. [PMID: 31722812 DOI: 10.1016/j.aprim.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/29/2019] [Accepted: 08/23/2019] [Indexed: 12/03/2022] Open
Abstract
Objetivo Describir la utilización y percepción de la necesidad de productos de apoyo e identificar su asociación con instrumentos para medir la dependencia y la sobrecarga de cuidados. Diseño Estudio transversal. Emplazamiento Atención Primaria del área sur de Pontevedra. Participantes Un total de 112 personas cuidadoras informales que atienden a 125 personas dependientes. Mediciones principales Mediante entrevista personal se recogen datos sobre la utilización y percepción de necesidad de estos productos. Además, se obtienen datos sociodemográficos e información referida al tiempo dedicado al cuidado diario, la sobrecarga del cuidador, el Baremo de Valoración de Dependencia y el indicador de dependencia DEP-6D. Se ha utilizado un contraste de medias para identificar si existen diferencias significativas en dichos indicadores en función de si utilizan o no los productos facilitadores. Se ha calculado una regresión logística para identificar aquellas variables asociadas con tener una necesidad no cubierta. Resultados Un 60% (IC 95%: 50,9-68,7) de las personas dependientes tienen necesidades no cubiertas de estos dispositivos. Estas necesidades se asocian, principalmente, con una renta familiar baja, un mayor grado de dependencia y una mejor salud del cuidador, aunque en situaciones de gran dependencia y muy mala salud del cuidador estas carencias se suavizan. Conclusiones Existe una fuerte asociación entre grado de dependencia y utilización de estos productos. Sin embargo, también hay un elevado porcentaje de la muestra con necesidades no cubiertas de estos productos que están asociadas tanto con la situación socioeconómica del hogar como con las características del dependiente y de la persona cuidadora.
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Nieto Rojas I, Valiente Maresca P, Alarcón Escalonilla AI, Almenara Rescalvo C, Mota Santana R, Orueta Sánchez R. [Functional decline risk in elderly patients not institutionalized]. Semergen 2019; 45:390-395. [PMID: 30898486 DOI: 10.1016/j.semerg.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/20/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the risk of functional decline (DF) by using several prediction scales. MATERIAL AND METHODS A multicentre, observational, cross-sectional study was conducted on a population of 70 years or more in the health area of ??Toledo. Institutionalised, terminal ill, and patients dependent for three or more basic activities of daily life, were excluded. The sample (480 patients) was calculated for an estimated DF prevalence of 15%, accuracy 2%, confidence level 95%, and 10% of estimated losses. Stratified sampling; first by conglomerates (Health Centres) and then systematic sampling (1/15) by list of patients ordered by age. Response rate: 98%. VARIABLES Sociodemographic, morbidity, questionnaires to assess the functional capacity for basic activities (Katz index), and tools (Lawton-Brody index) of daily life and risk prediction rules of DF (SHERPA, TRST, ISAR-PC and Inouye). Approved by the Clinical Research Ethics Committee of Toledo. RESULTS The mean age was 77.94 (SD: 6.27), with 54.4% women. Mean number of illnesses: 4.38 (SD: 2.17) and drugs: 5.57 (SD: 3.35). Risk of DF according to the prediction rules: SHERPA: 32.7% (95% CI: 28.52-36.88) (slight risk: 17.2% [95% CI: 13.83-20.57]; moderate: 9.7% [95% CI: 7.06-12.34] and high: 5.8% [95% CI: 3.72-7.88]); TRST: 42% (95% CI: 37.6-46.4); ISAR-PC: 75.4% (95% CI: 71.14-78.86); Inouye: 49.3% (95% CI: 44.84-53.76) (mean risk: 44.5% [95% CI: 40.07-48.93], and high: risk 4.8% [95% CI: 2.89-6.71]). CONCLUSIONS A significant percentage of patients are at risk of DF, but there is a wide variation between the different rules. In general, the risk is lower than that found in other studies, and it is necessary to validate new rules adapted to our environment.
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Affiliation(s)
- I Nieto Rojas
- Medicina de Familia, Servicio de Urgencias, Hospital Virgen de la Salud, SESCAM, Toledo, España.
| | - P Valiente Maresca
- Medicina de Familia, Centro de Salud de Navahermosa, SESCAM, Navahermosa, Toledo, España
| | | | - C Almenara Rescalvo
- Medicina de Familia, Centro de Salud de Torrijos, SESCAM, Torrijos, Toledo, España
| | - R Mota Santana
- Medicina de Familia, Centro de Salud de Sonseca, SESCAM, Sonseca, Toledo, España
| | - R Orueta Sánchez
- Medicina de Familia, Centro de Salud de Sillería, SESCAM, Toledo, España
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Casal Rodríguez B, Rivera Castiñeira B, Currais Nunes L. [Alzheimer's disease and the quality of life of the informal caregiver]. Rev Esp Geriatr Gerontol 2019; 54:81-87. [PMID: 30792138 DOI: 10.1016/j.regg.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/01/2018] [Accepted: 10/15/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Along with an ageing population, a higher incidence of chronic diseases leads to increasingly complex health profiles. The relationship between survival, dependence, and social and demographic trends affecting caregiving, has led to an increase in the negative consequences associated with care provision. In this context, an assessment needs to be made on the impact that caregiving has on the well-being of the caregivers. The main aim of this article is to study the factors that determine the Quality of Life (QoL) of those who provide informal care to people suffering from Alzheimer's disease (AD). METHODS A total of 175 caregivers of people with AD were recruited through the Galician Association for Relatives with Alzheimer. These caregivers completed a questionnaire (EQ-5D) that gathered sociodemographic and health variables, QoL, and care characteristics. Multiple regression models were calculated to explain the QoL of the caregivers. RESULTS Of the five dimensions that the EQ-5D used to describe health, anxiety/depression was the one that concerned the largest percentage of caregivers who declared the highest levels of severity. The key variables for explaining QoL are those related to caregiver health status, periods of rest during caregiving, and the presence of a second caregiver. CONCLUSIONS Maintaining a minimal QoL among the caregivers not only has repercussions on the caregivers themselves, but also has an impact on those receiving care and the entire health system, which would have to find replacements for those informal caregivers.
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Affiliation(s)
| | | | - Luis Currais Nunes
- Facultad de Economía y Empresa, Universidad de A Coruña, A Coruña, España
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16
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Bermejo F, Del Pozo-Rubio R. The impact of Dependency Act benefits on employment. Gac Sanit 2018; 33:341-347. [PMID: 30146179 DOI: 10.1016/j.gaceta.2017.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/26/2017] [Accepted: 12/26/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the amount of employment generated from the effective development of the Dependency Act in 2012, by evaluating the number of jobs depending on whether in-kind services or cash benefits were applied. METHODS The level and total costs of dependency were obtained by using the Survey on Disability, Personal Autonomy and Dependency Situations of 2008. The consumption of dependent households was collected from the Household Budget Survey of 2012 carried out by the Spanish Statistics Institute. The impact on employment was estimated using an extended Input-Output model based on Symmetric Input-Output Tables and labour data from the Spanish National Accounts Base. RESULTS The total estimated costs of dependency in 2012 were 4,545 million Euros for in-kind services and 2,662 for cash benefits. One hundred and ninety-five thousand, six hundred and sixty-eight jobs were generated in 2012 from dependency costs, and132,997 were linked to in-kind services and 62,671 to cash benefits. Every million Euros allocated for dependency by the Government returned 53.33 jobs linked to in-kind services and 46.21 to cash benefits. Furthermore, 341,505 jobs would have been created if dependency benefits had been exclusively offered via in-kind services. CONCLUSIONS Dependency benefits were equally distributed between in-kind services and cash benefits in 2012. Given that two out of three job positions generated from dependency benefits are linked to in-kind services, while the remaining third is generated by cash benefits, we conclude that around 146 thousand more jobs would have been generated if benefits had been offered as in-kind services instead of overusing cash benefits.
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Affiliation(s)
- Fernando Bermejo
- Department of Economics and Finance, Health and Social Research Centre, University of Castilla-La Mancha, Cuenca, Spain.
| | - Raúl Del Pozo-Rubio
- Department of Economics and Finance, Health and Social Research Centre, University of Castilla-La Mancha, Cuenca, Spain
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Navarro-Abal Y, López-López MJ, Climent-Rodríguez JA, Gómez-Salgado J. [Burden, empathy, and resilience in dependent people caregivers]. Gac Sanit 2018; 33:268-271. [PMID: 29439816 DOI: 10.1016/j.gaceta.2017.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/03/2017] [Accepted: 11/14/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. METHOD Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. RESULTS Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. CONCLUSIONS Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome.
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Affiliation(s)
- Yolanda Navarro-Abal
- Departamento de Psicología Social, Evolutiva y de la Educación, Facultad de Ciencias de la Educación, Universidad de Huelva, Huelva, España
| | - María José López-López
- Departamento de Psicología Clínica y Experimental, Facultad de Ciencias de la Educación, Universidad de Huelva, Huelva, España
| | - José Antonio Climent-Rodríguez
- Departamento de Psicología Social, Evolutiva y de la Educación, Facultad de Ciencias de la Educación, Universidad de Huelva, Huelva, España.
| | - Juan Gómez-Salgado
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Huelva, Huelva, España; Universidad Espíritu Santo, Guayaquil, Ecuador
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Martínez Candela J, Sangrós González J, García Soidán FJ, Millaruelo Trillo JM, Díez Espino J, Bordonaba Bosque D, Ávila Lachica L. Chronic renal disease in spain: prevalence and related factors in persons with diabetes mellitus older than 64 years. Nefrologia 2018; 38:401-413. [PMID: 29428153 DOI: 10.1016/j.nefro.2017.11.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/11/2017] [Accepted: 11/28/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals ≥ 65 years of age and represent a major public health problem. OBJECTIVES To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. METHODS Observational, cross-sectional, multicenter, Spanish epidemiological study. Patients with known type 2 diabetes mellitus, age ≥ 65 years of age treated in Primary Care were included. We collected demographic, anthropometric and analytical variables from the previous 12 months, including the albumin-to-creatinine ratio and estimated glomerular filtration rate to evaluate renal function. RESULTS The prevalence of CKD was 37.2% (95% CI, 34.1-40.3%), renal failure was 29.7% (95% CI, 26.8-32.6%) and increased albuminuria was 20.6% (95% CI, 17.3-23.9%), moderately increased albuminuria was 17.8% (95% CI, 14.7-20.9%) and severely increased albuminuria was 2.8% (95% CI, 1.4-4.2%). In turn, the prevalence of CKD categories were: G1 1.3% (95% CI, 0.6-2%), G2 6.2% (95% CI, 4.6-7.8%), G3a 17.2% (95% CI, 14.8-19.6%), G3b 9.8% (95% CI, 7.9-11.7%), G4 2% (95% CI, 1.1-2.9%) and G5 0.7% (95% CI, 0.2-1.2%). In the multivariate analysis, after adjusting for the remaining variables, CKD was associated with elderly age (OR 5.13, 95% CI, 3.15-8.35), high comorbidity (OR 3.36. 95% CI, 2.2-5.12) and presence of antihypertensive treatment (OR 2.43. 95% CI, 1.48-4.02). CONCLUSIONS CKD is frequent in the diabetic population ≥ 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes.
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Villarejo Galende A, Eimil Ortiz M, Llamas Velasco S, Llanero Luque M, López de Silanes de Miguel C, Prieto Jurczynska C. Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia. Neurologia 2021; 36:39-49. [PMID: 29249303 DOI: 10.1016/j.nrl.2017.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. METHODS We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. CONCLUSIONS Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia.
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Coloma-Carmona A, Carballo JL, Rodríguez-Marín J, Pérez-Carbonell A. Use and dependence on opioid drugs in the Spanish population with chronic pain: Prevalence and differences according to sex. Rev Clin Esp 2017; 217:315-319. [PMID: 28501291 DOI: 10.1016/j.rce.2017.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/24/2017] [Accepted: 03/29/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyse the prevalence in the use and dependence on opioid drugs in the Spanish population with chronic pain and evaluate the differences according to sex. PATIENTS AND METHODS The demographic variables, opioid treatment characteristics and use of other substances were assessed in 229 users of opioid drugs. A descriptive bivariate analysis of the data was performed. RESULTS Forty-six percent of the patients met the criteria of dependence on opioid drugs (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition [DSM-IV-TR]). Alcohol and cannabis consumption was greater in the men. The rates of dependence on the use of opioid drugs were significantly higher in the extended treatments. CONCLUSIONS Planning for treatments with opioids and strategies for preventing inappropriate use should not depend on the patient's sex. We need further studies on the medical and psychological variables related to the use of and dependence on opioids.
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Affiliation(s)
- A Coloma-Carmona
- Centro de Psicología Aplicada, Universidad Miguel Hernández, Elche, Alicante, España.
| | - J L Carballo
- Centro de Psicología Aplicada, Universidad Miguel Hernández, Elche, Alicante, España
| | - J Rodríguez-Marín
- Centro de Psicología Aplicada, Universidad Miguel Hernández, Elche, Alicante, España
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Estrada Fernández ME, Gil Lacruz AI, Gil Lacruz M, Viñas López A. [Dependent relative: Effects on family health]. Aten Primaria 2017; 50:23-34. [PMID: 28431761 PMCID: PMC6836982 DOI: 10.1016/j.aprim.2016.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 11/16/2022] Open
Abstract
Objetivos Los objetivos de este trabajo son analizar cómo influye el hecho de que en el hogar haya una persona dependiente en el estado de salud de las personas con quien convive y en los estilos de vida; compararlo con otras situaciones que impliquen dedicación de tiempo y energía, y analizar diferencias de género y edad en cada etapa del ciclo vital. Diseño Estudio descriptivo transversal analizando datos secundarios. Emplazamiento El método de recogida de información es el de entrevista personal asistida por ordenador en las viviendas seleccionadas, realizada por el Ministerio de Sanidad, Servicios Sociales e Igualdad. Participantes Un total de 19.351 individuos mayores de 25 años que realizaron la Encuesta Nacional de Salud 2011-2012 (ENSE 2011/2012). Mediciones principales Estudio llevado a cabo con datos sobre la sociedad española procedentes de la ENSE 2011/12. Como marco empírico, seleccionamos el modelo Logit, reportando los datos en odds ratio. Las estimaciones se repiten de manera independiente por submuestras de edad y género. Resultados La salud de las personas que conviven con una persona dependiente es peor que la de aquellas personas que no conviven (hasta 5 veces más riesgo de tener problemas de salud), especialmente si se es mujer, de edad avanzada, con un nivel educativo bajo o no trabaja. También ser cuidador reduce la probabilidad de mantener unos hábitos saludables como son el realizar ejercicio, el descanso o una dieta equilibrada. Conclusiones Por lo general, convivir con una persona dependiente reduce la probabilidad de mantener estilos de vida saludables y deteriora la salud. Encontramos importantes diferencias de género y edad.
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Affiliation(s)
- M Eugenia Estrada Fernández
- Departamento de Psicología, Escuela Universitaria de Enfermería, Universidad de Zaragoza, Huesca, España; Unidad de Psiquiatría, Hospital Sagrado Corazón de Jesús, Huesca, España.
| | - Ana I Gil Lacruz
- Departamento de Organización y Dirección de Empresas, Universidad de Zaragoza, Zaragoza, España
| | - Marta Gil Lacruz
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, España
| | - Antonio Viñas López
- Unidad de Cirugía Ortopédica y Traumatología, Hospital San Jorge, Huesca, España
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Aranguren-Ruiz MI, Acha-Arrieta MV, Casas-Fernández de Tejerina JM, Arteaga-Mazuelas M, Jarne-Betrán V, Arnáez-Solis R. Risk factors for mortality after surgery of osteoporotic hip fracture in patients over 65 years of age. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017; 61:185-192. [PMID: 28363666 DOI: 10.1016/j.recot.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 12/23/2016] [Accepted: 02/11/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate, from a clinical perspective, and with easily identifiable variables, those factors that influence the survival of patients admitted to a care unit designed for the comprehensive treatment of patients with hip fracture after being surgically treated. MATERIAL AND METHODS A prospective study was conducted on a cohort of patients (n=202) aged 65 years or older with a low impact hip fracture, who were surgically intervened in a tertiary hospital. An analysis was performed to determine mortality at 90 days, and at one and 2years after surgery using demographic, clinical, analytical, and functional variables. RESULTS The independent risk factors of mortality in the 3periods analysed were age (P=.047, P=.016, and P=.000 at 90 days, 1, and 2 years, respectively) and a low Barthel index (P=.014, P=.005, and P=.004 to 90 days, 1, and 2 years, respectively). Male sex (P=.004) and a high risk for anaesthesia (P=.011) were only independent risk factors of mortality at 2years after surgery. DISCUSSION AND CONCLUSION Age and dependency were the major determining factors of mortality at 30 days, 1, and 2 years after surgery for hip fracture. Both are easily measurable to identify patients susceptible to poor outcomes, and could benefit from a more thorough care plan.
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Affiliation(s)
- M I Aranguren-Ruiz
- Servicio de Gestión de la Prestación Farmacéutica, Servicio Navarro de Salud, Pamplona, España.
| | - M V Acha-Arrieta
- Servicio de Medicina Interna, Complejo Hospitalario B de Navarra, Pamplona, España
| | | | | | - V Jarne-Betrán
- Servicio de Medicina Interna, Hospital García Orcoyen, Estella, España
| | - R Arnáez-Solis
- Servicio de Medicina Interna, Complejo Hospitalario B de Navarra, Pamplona, España
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Inzitari M, Calle A, Esteve A, Casas Á, Torrents N, Martínez N. [Do you measure gait speed in your daily clinical practice? A review]. Rev Esp Geriatr Gerontol 2017; 52:35-43. [PMID: 26908071 DOI: 10.1016/j.regg.2015.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/18/2015] [Accepted: 12/22/2015] [Indexed: 06/05/2023]
Abstract
Gait speed (GS), measured at usual pace, is an easy, quick, reliable, non-expensive and informative measurement. With a standard chronometer, like those that currently found in mobile phones, and with two marks on the floor, trained health professionals obtain a more objective and quick measurement compared with many geriatric scales used in daily practice. GS is one of the pillars of the frailty phenotype, and is closely related to sarcopenia. It is a powerful marker of falls incidence, disability and death, mostly useful in the screening of older adults that live in the community. In recent years, the evidence is reinforcing the usefulness of GS in acute care and post-surgical patients. Its use in patients with cognitive impairment is suggested, due to the strong link between cognitive and physical function. Although GS meets the criteria for a good geriatric screening tool, it is not much used in clinical practice. Why? This review has different aims: (i)disentangling the relationship between GS and frailty; (ii)reviewing the protocols to measure GS and the reference values; (iii)reviewing the evidence in different clinical groups (older adults with frailty, with cognitive impairment, with cancer or other pathologies), and in different settings (community, acute care, rehabilitation), and (iv)speculating about the reasons for its poor use in clinical practice and about the gaps to be filled.
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Affiliation(s)
- Marco Inzitari
- Parc Sanitari Pere Virgili, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España.
| | - Alicia Calle
- Parc Sanitari Pere Virgili, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - Anna Esteve
- Parc Sanitari Pere Virgili, Barcelona, España
| | - Álvaro Casas
- Servicio de Geriatría, Complejo Hospitalario de Navarra. IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, España
| | | | - Nicolás Martínez
- Servicio de Geriatría, Complejo Hospitalario de Navarra. IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, España; REDISSEC, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, España
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Rodríguez-González AM, Rodríguez-Míguez E, Duarte-Pérez A, Díaz-Sanisidro E, Barbosa-Álvarez Á, Clavería A. [Cross-sectional study of informal caregiver burden and the determinants related to the care of dependent persons]. Aten Primaria 2016; 49:156-165. [PMID: 27423241 PMCID: PMC6875977 DOI: 10.1016/j.aprim.2016.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the burden of informal carers of dependent people and to identify related variables. DESIGN Descriptive observational cross-sectional study. LOCATION Primary Health Care in the southern area of Pontevedra. PARTICIPANTS 97 caregivers of dependent persons. KEY MEASUREMENTS We collected socioeconomic data and health conditions from caregivers and dependent persons, time spent on the daily care and caregiver burden (Zarit abbreviate) through a personal interview. Besides the description of the sample-including their burden level-, a contrast mean was used to identify characteristics that influenced in punctuation of Zarit scale. A logistic regression was used to analyse characteristics that increase the likelihood to experiment burden. RESULTS 61.9% of caregivers are subject to intense burden. The item on the scale which contributes most to the caregiver burden is the lack of time for oneself, followed by the negative effects of interpersonal relationships. Contrast means shows that degree of relationship, number of care hours, caregiver health and aggressiveness of dependent persons produce significant differences in Zarit scale. Physic and psychological health of caregivers and aggressiveness of dependent persons is associated with the likelihood of developing caregiver burden. CONCLUSIONS Informal caregivers of dependent persons show a high level of burden, both related to their characteristics and those of the dependent persons. Caregiver burden rethinks the need for public policies focused on dependence to adopt an integrative caregiver-dependent vision.
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Affiliation(s)
| | - Eva Rodríguez-Míguez
- Departamento de Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Universidad de Vigo, Vigo, España
| | | | | | | | - Ana Clavería
- Atención Primaria, Estrutura Organizativa de Xestión Integrada (EOXI) de Vigo, Vigo, España
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Maestre-Miquel C, Figueroa C, Santos J, Astasio P, Gil P. [Counseling and preventive action in elderly population in hospitals and residences in Spain]. Aten Primaria 2016; 48:550-556. [PMID: 26920448 PMCID: PMC6877857 DOI: 10.1016/j.aprim.2015.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/08/2015] [Accepted: 10/25/2015] [Indexed: 12/24/2022] Open
Abstract
Objetivos Conocer el perfil sociosanitario de los pacientes mayores atendidos en consultas; conocer las acciones preventivas que se llevan a cabo, de forma rutinaria, en hospitales, residencias geriátricas y otros centros asistenciales en España. Diseño Estudio descriptivo transversal, basado en un cuestionario a médicos que atienden a población mayor de 65 años en España (2013). Emplazamiento Centros de diferentes comunidades autónomas en España. Participantes: Un total de 420 médicos de hospitales, residencias y otros centros. Se obtuvieron datos de 840 consultas a pacientes geriátricos. Mediciones principales Variables principales de resultados: dependencia, comorbilidad, motivo de consulta, actuación en consulta y recomendación de estilos de vida saludable. Factor asociado, tipo de institución en la que se atendió al paciente. Análisis de prevalencias y diferencias con Chi-cuadrado. Resultados El 66,7% presentaban dependencia, siendo mayor entre las mujeres: 68,9% vs 62,4% (p = 0,055). El 88,6% de mujeres atendidas con 85 o más años presentaban comorbilidad, mientras que en hombres de ese mismo grupo de edad eran un 79,8%. Solo un 6,6% de pacientes con comorbilidad recibieron recomendaciones saludables durante la consulta. El 79,6% de pacientes atendidos en hospitales recibieron recomendaciones de estilo de vida saludable, mientras que en las residencias geriátricas las recibieron el 59,62% de los pacientes (p < 0,001). Conclusiones Se detecta una escasa acción preventiva y de promoción de la salud hacia las personas mayores, con diferencias entre hospitales y residencias geriátricas. Parece necesario incentivar la actitud promotora de salud y las intervenciones preventivas en la práctica clínica gerontológica.
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Affiliation(s)
- Clara Maestre-Miquel
- Departamento de Enfermería y Fisioterapia, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, España.
| | - Carmen Figueroa
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Juana Santos
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Paloma Astasio
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense, Madrid, España
| | - Pedro Gil
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense, Madrid, España; Departamento de Geriatría, Hospital Clínico San Carlos, Madrid, España
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Pinzón-Pulido S, Garrido Peña F, Reyes Alcázar V, Lima-Rodríguez JS, Raposo Triano MF, Martínez Domene M, Alonso Trujillo F. [Predictors of institutionalization of elderly persons in dependency situation in Andalusia]. Enferm Clin 2015; 26:23-30. [PMID: 26363992 DOI: 10.1016/j.enfcli.2015.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 08/02/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Identifying preferences regarding type of care and risk factors for institutionalization of elderly persons in dependency situations in Andalusia. METHODS The data on 200,039 persons registered in the System for Autonomy and Dependency Care over the period 2007-2012 were analysed. The study population was described in terms of: age, dependency situation, preferences, support network and clinical factors at the time of inclusion in the study. Separate analysis was made for men and women. A logistic regression model was designed to determine the risk factors for institutionalization for each sex. RESULTS 87,4% of women and 85,9% of men expressed their wish to receive care in their own home. The risk of institutionalization is three times higher among men than among women. Among women, the risks of institutionalization are: level of dependency, wishing to move into a residential care home, medium consistency and fragility of support network and being diagnosed with dementia. Among men, the risks are: wishing to move into a residential care home and low or medium consistency of support network. CONCLUSIONS Care in the home is the preferred alternative for elderly persons in dependency situations. The risk of institutionalization is conditioned more by the preferences of the person and their family and the characteristics of the support network than by individual's clinical condition.
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Camacho A, Esteban J, Paradas C. Report by the Spanish Foundation for the Brain on the social impact of amyotrophic lateral sclerosis and other neuromuscular disorders. Neurologia 2018; 33:35-46. [PMID: 25825074 DOI: 10.1016/j.nrl.2015.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/07/2015] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION A thorough knowledge of the socioeconomic scope of neuromuscular disease is essential for managing resources and raising social awareness. DEVELOPMENT Our group reviewed current data on the epidemiology, mortality and dependence rates, and socioeconomic impact of amyotrophic lateral sclerosis and neuromuscular diseases in Spain. We also recorded how neurological care for these patients is organised. CONCLUSIONS Neuromuscular disorders are a very heterogeneous group of diseases, and some are very rare. These disorders account for between 2.8% and 18% of the total motives for a neurological consultation. In Spain, prevalence and incidence figures for amyotrophic lateral sclerosis are similar to those in other countries; however, figures for patients with other neuromuscular diseases are not known. Since the diseases are chronic, progressive, and debilitating, they cause considerable disability and dependence, which in turn directly affects healthcare and social costs associated with the disease. The costs generated by one patient with amyotrophic lateral sclerosis or Duchenne disease have been calculated at about 50 000 euros per year. Neuromuscular disease shows aetiological, diagnostic, and prognostic complexity, and it requires multidisciplinary management. Follow-up for these patients should be entrusted to specialised units.
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Chirveches-Pérez E, Roca-Closa J, Puigoriol-Juvanteny E, Ubeda-Bonet I, Subirana-Casacuberta M, Moreno-Casbas MT. [Care and implications for caregivers of surgical patients at home]. Enferm Clin 2014; 24:330-8. [PMID: 25240988 DOI: 10.1016/j.enfcli.2014.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/03/2014] [Accepted: 07/31/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify the care given by informal caregivers to patients who underwent abdominal surgery in the Consorci Hospitalari of Vic (Barcelona). To compare the responsibility burden for those caregivers in all the different stages of the surgical process. To determine the consequences of the care itself on the caregiver's health and to identify the factors that contribute to the need of providing care and the appearance of consequences for the caregivers in the home. METHODOLOGY A longitudinal observational study with follow-up at admission, at discharge and 10 days, of 317 non-paid caregivers of patients who suffer underwent surgery. The characteristics of caregivers and surgical patients were studied. The validated questionnaire, ICUB97-R based on the model by Virginia Henderson, was used to measure the care provided by informal caregivers and its impact on patient quality of life. RESULTS Most of the caregivers were women, with an average age of 52.9±13.7 years without any previous experience as caregivers. The greater intensity of care and impact was observed in the time when they arrived home after hospital discharge (p<0.05). The predictive variables of repercussions were being a dependent patient before the surgical intervention (β=2.93, p=0.007), having a cancer diagnosis (β=2.87, p<.001) and time dedicated to the care process (β=0.07, p=0.018). CONCLUSIONS Caregivers involved in the surgical process provide a great amount of care at home depending on the characteristics of patients they care for, and it affects their quality of life.
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Affiliation(s)
| | - Josep Roca-Closa
- Servicio de Cirugía General, Consorci Hospitalari de Vic, Vic, Barcelona, España
| | | | - Inmaculada Ubeda-Bonet
- Departamento de Salud Pública, Mental y Maternoinfantil, Universidad de Barcelona, Barcelona, España
| | | | - María Teresa Moreno-Casbas
- Unidad de Investigación en Cuidados de Salud (Investén-isciii), Instituto de Salud Carlos III, Madrid, España
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