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Sutil DV, Moreira BDS, Canever JB, Cândido LM, Danielewicz AL, Lima-Costa MF, Avelar NCPD. Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil. CAD SAUDE PUBLICA 2024; 40:e00141623. [PMID: 38695455 PMCID: PMC11057486 DOI: 10.1590/0102-311xen141623] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 05/06/2024] Open
Abstract
This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.
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Affiliation(s)
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | | | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Coelho ACR, Cruz EBDS, Radicchi HZ, Mattos EBT, Novelli MMPC, de Souza FG, Goulart R, Ribeiro CL. Effects of training Community Health Agents on dementia: a quasi-experimental study. Rev Bras Enferm 2024; 77:e20230027. [PMID: 38511785 PMCID: PMC10941676 DOI: 10.1590/0034-7167-2023-0027] [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: 02/28/2023] [Accepted: 11/07/2023] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES to evaluate the knowledge of Community Health Agents about dementia before and after the training workshop for detecting signs of the disease. METHODS a quasi-experimental study with 33 community agents, in which sociodemographic information and knowledge about dementia were collected and assessed using the Alzheimer's Disease Knowledge Scale before and after the workshop. There were 10 weekly, online, synchronous meetings. The Student's t-test for related samples was used, and the effect size was calculated. RESULTS while the average score on the initial assessment, using the measurement instrument, was 16.3, it was 21.24 in the final assessment. An increase in the scale score was observed after participating in the workshop, with a value of 4.94. CONCLUSIONS it is urgent to invest in the ongoing education of these professionals for greater awareness in the timely detection of dementia cases in primary care and awareness of potentially modifiable factors.
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Affiliation(s)
| | | | | | | | | | | | - Rubens Goulart
- Secretaria Municipal de Saúde de Santos. Santos, São Paulo, Brazil
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Peña-Silva RA. De la investigación a la acción: estrategias para el manejo de las enfermedades crónicas no transmisibles. Biomedica 2023; 43:5-8. [PMID: 38207147 PMCID: PMC10911802 DOI: 10.7705/biomedica.7354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Indexed: 01/13/2024]
Affiliation(s)
- Ricardo A Peña-Silva
- Facultad de Medicina, Universidad de los Andes, Bogotá, D.C., Colombia Lown Scholars Program, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Silva JDPD, Martins IV, Braga LHR, Oliveira CMD, Lima-Costa MF, Braga LDS, Torres JL. Differences in determinants of active aging between older Brazilian and English adults: ELSI-Brazil and ELSA. CAD SAUDE PUBLICA 2023; 39:e00076823. [PMID: 37851723 PMCID: PMC10599105 DOI: 10.1590/0102-311xen076823] [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: 04/26/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 10/20/2023] Open
Abstract
This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval - 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies.
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Affiliation(s)
| | | | | | | | - Maria Fernanda Lima-Costa
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
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Soares MM, Caldeira TCM, Sousa TMD, Rezende LFMD, Claro RM. Leisure time physical activity among older adults in Brazil: a time series analysis of a population-based survey (2009-2020). CAD SAUDE PUBLICA 2023; 39:e00212622. [PMID: 37820228 PMCID: PMC10566556 DOI: 10.1590/0102-311xen212622] [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: 11/22/2022] [Revised: 03/22/2023] [Accepted: 05/11/2023] [Indexed: 10/13/2023] Open
Abstract
The practice of leisure time physical activity brings several health benefits, such as the prevention of noncommunicable diseases. Investigating the temporal trend of physical activity practice in older adults by sociodemographic characteristics and geographical regions could be important to plan public health policies and effective interventions. This is a time series study that analyzes the temporal trend of leisure time physical activity among Brazilian older adults with data from 2009 to 2020. For this, we used a sample of 186,097 older adults (≥ 60 years old) obtained from the Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview (Vigitel) (2009-2020). Information on leisure time physical activity and sociodemographic and health characteristics were collected. Prais-Winsten regression was used to identify significant trends in the annual variation of the leisure time physical activity indicators. Practice of ≥ 150 minutes/week of moderate intensity leisure time physical activity varied from 23.3% to 27.5% (0.41p.p./year) (2009-2020), with a higher increase during 2015-2020 (0.59p.p./year). The increase in the most recent period occurred among men, aged from 60 to 69 years, with lower educational level, residing in the Northeast Region, and without self-reported chronic diseases. These results may contribute to the evaluation of Brazilian health policies targeting the leisure time physical activity practice in older adults.
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de Araújo PO, Soares IMSC, do Vale PRLF, de Sousa AR, Aparicio EC, Carvalho ESDS. Ageism directed to older adults in health services: A scoping review. Rev Lat Am Enfermagem 2023; 31:e4019. [PMID: 37820219 PMCID: PMC10557401 DOI: 10.1590/1518-8345.6727.4020] [Citation(s) in RCA: 1] [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: 02/28/2023] [Accepted: 07/20/2023] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE to map the expressions of ageism directed to older adults in health services and the respective coping measures. METHOD a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. RESULTS the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. CONCLUSION the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions. (1) Ageism expressions involve interpersonal and institutional relationships. (2) Ageism directed to older adults permeates from diagnosis to treatment. (3) The coping measures comprise educational actions and also scientific research studies. (4) It is necessary to recognize the presence of ageism in health services. (5) It is necessary to recognize care/neglect practices guided by age bias.
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de Araújo PO, Soares IMSC, do Vale PRLF, de Sousa AR, Aparicio EC, Carvalho ESDS. Ageism directed to older adults in health services: A scoping review. Rev Lat Am Enfermagem 2023; 31:e4019. [PMID: 37820219 PMCID: PMC10557401 DOI: 10.1590/1518-8345.6727.4019] [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: 02/28/2023] [Accepted: 07/20/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE to map the expressions of ageism directed to older adults in health services and the respective coping measures. METHOD a scoping review of primary studies in English, Spanish and Portuguese, without time delimitation and collected from 14 databases. Selection of the titles, abstracts and full text was in charge of two independent and blinded reviewers, totaling a corpus comprised by 41 articles. Data extraction was performed by pairs. The data were presented in narrative summaries and charts. RESULTS the ageism expressions are understood at the interpersonal level through images and attitudes that depreciate, devalue life and delegitimize older adults' needs, as well as at the institutional level, which confers barriers to accessing health services, generating non-assistance and neglect. The coping measures consist of educational interventions and expansion of communication channels between aged people, health professionals and managers. CONCLUSION the results may make health professionals vigilant for care/neglect guided by age bias and sensitive for coping with ageism by obtaining diverse scientific knowledge. The analysis of the phenomenon in the Unified Health System context constitutes a knowledge gap, as well as the implicit ageism expressions. (1) Ageism expressions involve interpersonal and institutional relationships. (2) Ageism directed to older adults permeates from diagnosis to treatment. (3) The coping measures comprise educational actions and also scientific research studies. (4) It is necessary to recognize the presence of ageism in health services. (5) It is necessary to recognize care/neglect practices guided by age bias.
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Li CY, Aguila E, Arthur P, Peniche J, Gútierrez M, Hernández M, Wong R. Assigning lifetime occupation domains for older Mexicans: MHAS-O*NET linkage protocol. Salud Publica Mex 2023; 65:425-433. [PMID: 38060921 PMCID: PMC11006013 DOI: 10.21149/14635] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/06/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE We developed a MHAS (Mexican Health and Aging Study) and O*NET (Occupational Information Network) linkage to allow global researchers using MHAS data to assign lifetime occupation domains for older Mexicans. MATERIALS AND METHODS Three bilingual raters independently matched 440 records with 132 unique occupation codes from the 2012 MHAS. We used a modified Delphi technique to reach agreements. To assess reliability, we compared the distribution of observations between the MHAS file and the MHAS-O*NET linked file across five job categories (upper white collar, lower white collar, upper blue collar, low blue collar, and agriculture/fishing/forestry). The Institutional Review Board at the University of Texas Medical Branch reviewed and approved the research (IRB # 21-0268). RESULTS Using the developed 1:1 MHAS-ONET linkage, consistency between MHAS and ONET was 97.4% across the five job categories. CONCLUSION This MHAS-O*NET linkage will allow researchers to analyze the association between lifetime occupation and multiple dimensions of health, functionality, and retirement determinants for a low-middle income country with a large proportion of workers in the informal sector.
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Affiliation(s)
- Chih-Ying Li
- Department of Occupational Therapy, School of Health Professions, University of Texas Medical Branch at Galveston. Texas, United States..
| | - Emma Aguila
- Price School of Public Policy, University of Southern California. California, United States..
| | - Paul Arthur
- Department of Rehabilitation Sciences, Florida Gulf Coast University. Florida, United States..
| | - Jorge Peniche
- Price School of Public Policy, University of Southern California. California, United States..
| | - Mariela Gútierrez
- School of Public and Population Health, University of Texas Medical Branch at Galveston. Texas, United States..
| | - Mónica Hernández
- School of Public and Population Health, University of Texas Medical Branch at Galveston. Texas, United States..
| | - Rebeca Wong
- Department of Population Health & Health Disparities, School of Public and Population Health, University of Texas Medical Branch at Galveston. Texas, United States. Sealy Center on Aging, University of Texas Medical Branch at Galveston. Texas, United States. WHO/PAHO Collaborating Center on Aging and Health, University of Texas Medical Branch at Galveston. Texas, United States..
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Bolbinski P, Nascimento-Souza MA, Lima-Costa MF, Peixoto SV. Consumption of fruits and vegetables among older adults: findings from the ELSI-Brazil study. CAD SAUDE PUBLICA 2023; 39:e00158122. [PMID: 37466546 PMCID: PMC10494691 DOI: 10.1590/0102-311xen158122] [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: 09/02/2022] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 07/20/2023] Open
Abstract
This study aimed to assess the prevalence of recommended consumption of fruits and vegetables and their associated factors in a national sample representative of the Brazilian population aged 60 or over. Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted from 2015 to 2016, including 4,982 older individuals, were used. The recommended consumption of fruits and vegetables was assessed based on questions on the weekly and daily frequency of fruits, natural fruit juice, and vegetables. Intake of five or more servings of these foods on five or more days per week was considered as recommended consumption. Exploratory variables included socio-demographic characteristics, health behaviors, health conditions, and use of health services. Univariate and multiple logistic regression were used to examine the factors associated with the recommended consumption of fruits and vegetables. The prevalence of recommended consumption of fruits and vegetables was 12.9% (95%CI: 11.5-14.3). This consumption showed associations with gender (women - OR = 1.40; 95%CI: 1.08-1.82), age group (80 years or older - OR = 1.66; 95%CI: 1.16-2.37), education level (8 years or more - OR = 2.07; 95%CI: 1.51-2.86), smoking (former smokers - OR = 0.69; 95%CI: 0.55-0.85 and current smokers - OR = 0.50; 95%CI: 0.33-0.77) and medical appointments in the previous 12 months (OR = 1.88; 95%CI: 1.31-2.71). Our findings showed a low prevalence of the recommended consumption of fruits and vegetables among older Brazilian adults, drawing attention to the need for policies aimed at increasing this consumption in the studied population.
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Affiliation(s)
- Paula Bolbinski
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | | | - Maria Fernanda Lima-Costa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
- Programa de Pós-graduação em Saúde Púbica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Sérgio Viana Peixoto
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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da Costa GM, Shimizu HE, Sanchez MN. Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District. Rev Bras Enferm 2022; 76:e20220170. [PMID: 36542054 PMCID: PMC9749770 DOI: 10.1590/0034-7167-2022-0170] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/21/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District. METHODS Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%. RESULTS There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999). CONCLUSIONS Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.
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Tavares DMDS, Oliveira NGN, Marchiori GF, Guimarães MSF, Santana LPM. Elderly individuals living by themselves: knowledge and measures to prevent the novel coronavirus. Rev Lat Am Enfermagem 2020; 28:e3383. [PMID: 33174993 PMCID: PMC7647413 DOI: 10.1590/1518-8345.4675.3383] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE to describe the occurrence of COVID-19 and the health services used by elderly individuals living by themselves; identify the knowledge held by elderly individuals regarding the transmission, signs and symptoms of COVID-19, as well as factors associated with poor knowledge of preventive measures according to sociodemographic and clinical variables. METHOD cross-sectional survey conducted by telephone or mobile with 123 elderly individuals living by themselves in the Health Macro-Region of Triângulo Sul in the state of Minas Gerais, Brazil. Descriptive analysis was performed along with bivariate and multiple linear regression (p<0.05). RESULTS most elderly individuals did not present COVID-19 signs and symptoms (97.5%), were aware of how it is transmitted (86.6%), and of its signs and symptoms (90.8%). The elderly individuals were familiar with four preventive measures on average. After social distancing began, 85.7% of them left home and implemented three preventive measures on average, the most frequent of which was the use of face masks (99.0%). Being a man (p=0.001), 80 years old or older (p=0.045), and having fewer years of schooling (p=0.010) were associated with having less knowledge regarding the COVID-19 preventive measures. CONCLUSION the elderly individuals were knowledgeable on COVID-19, but did not implement all the preventive measures. Male elderly individuals living by themselves with a low educational level are more vulnerable to COVID-19.
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Affiliation(s)
- Darlene Mara dos Santos Tavares
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
| | | | | | - Mariana Silva Freitas Guimarães
- Universidade Federal do Triângulo Mineiro, Uberaba, MG,
Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Lenniara Pereira Mendes Santana
- Universidade Federal do Triângulo Mineiro, Uberaba, MG,
Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
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Morillo-Verdugo R, Robustillo-Cortés MDLA, Abdel-Kader Martín L, de Sotomayor Paz MÁ, de León Naranjo FL, AlmeidaGonzález CV. Determination of a cutoff value for medication regimen complexity index to predict polypharmacy in HIV+ older patient. Rev Esp Quimioter 2019; 32:458-464. [PMID: 31528986 PMCID: PMC6790892] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE HIV+ patients have increased their life expectancy with a parallel increase in age-associated co-morbidities and pharmacotherapeutic complexity. The aim of this study was to determine an optimal cutoff value for Medication regimen complexity index (MRCI) to predict polypharmacy in HIV+ older patients. METHODS A transversal observational single cohort study was conducted at a tertiary Hospital in Spain, between January 1st up to December 31st, 2014. Patients included were HIV patients over 50 years of age on active antiretroviral treatment. Prevalence of polypharmacy and it pattern were analyzed. The pharmacotherapy complexity value was calculated through the MRCI. Receiver operating characteristic curve analyses were used to calculate the area under the curve (AUC) for the MRCI value medications to determine the best cutoff value for identifying outcomes including polypharmacy. Sensitivity and specificity were also calculated. RESULTS A total of 223 patients were included. A 56.1% of patients had polypharmacy, being extreme polypharmacy in 9.4% of cases. Regarding the pattern of polypharmacy, 78.0% had a cardio-metabolic pattern, 12.0% depressive-psychogeriatric, 8.0% mixed and 2.0% mechanical-thyroidal. The ROC curve demonstrated that a value of medication complexity index of 11.25 point was the best cutoff for predict polypharmacy (AUC=0.931; sensitivity= 77.6%; specificity=91.8%). CONCLUSIONS A cut-off value of 11.25 for MRCI is proposed to determine if a patient reaches the criterion of polypharmacy. In conclusion, the concept of polypharmacy should include not only the number of prescribed drugs but also the complexity of them.
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Affiliation(s)
| | - Mª de las Aguas Robustillo-Cortés
- Valme Hospital (Pharmacy Department). Seville, Spain.,Correspondence: Maria de las Aguas Robustillo-Cortés. Pharmacy Department, Valme Hospital, Av Bellavista s/n 41014, Seville, Spain. Phone: +34955015467 FAX: 34955015461 E-mail:
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Villada-Gómez JS, González-Correa CH, Marulanda-Mejía F. Provisional cut-off points for the diagnosis of sarcopenia in elderly people from Caldas (Colombia). Biomedica 2018; 38:521-6. [PMID: 30653866 DOI: 10.7705/biomedica.v38i4.4302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/22/2018] [Indexed: 01/06/2023]
Abstract
Introduction: Sarcopenia is defined as a decrease in muscle mass associated with the reduction of performance and physical function. It is an indicator of adverse outcomes in elderly people. Its diagnosis requires body composition data of healthy young population to establish reference values of low muscle mass.
Objective: To establish a provisional cut-off point for sarcopenia in the elderly population from Caldas based on the skeletal muscle composition data of young people using electric bioimpedance.
Materials and methods: Body composition data from healthy young people (18 to 35 years old) were used to calculate the skeletal muscle mass index. The Kolmogorov-Smirnov test was applied to evaluate the normality of the data and then the average and standard deviation of muscle mass index were established for both men and women.
Results: Based on these data, we established as low muscle mass a skeletal muscle mass index of two standard deviations below the mean of the muscular mass index in young people. The cut-off points were 6.42 kg/m2 and 8.39 kg/m2 for women and men, respectively.
Conclusion: This is the first study that offers a description of skeletal muscle body composition in young Colombians and provides cut-off points for the diagnosis of sarcopenia in the elderly population from the Central-Andean region. The data gathered are similar to those proposed by some Asian authors, which shows that the population of this Colombian region has body composition characteristics similar to those from Asia.
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Bernard C, Dabis F, de Rekeneire N. Physical function, grip strength and frailty in people living with HIV in sub-Saharan Africa: systematic review. Trop Med Int Health 2017; 22:516-525. [PMID: 28170120 DOI: 10.1111/tmi.12852] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To present the current knowledge on physical function, grip strength and frailty in HIV-infected patients living in sub-Saharan Africa, where the phenomenon is largely underestimated. METHODS A systematic search was conducted on MEDLINE, Scopus and African Index Medicus. We reviewed articles on sub-Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016. RESULTS Of 537 articles, 12 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these five articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison with uninfected patients. One study reported that PLHIV were more likely to be frail than HIV-uninfected individuals (19.4% vs. 13.3%), whereas another reported no statistical difference. CONCLUSION Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries, but current data are insufficient to characterise the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines.
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Affiliation(s)
- Charlotte Bernard
- INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.,School of Public Health (ISPED), University of Bordeaux, Bordeaux, France
| | - François Dabis
- INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.,School of Public Health (ISPED), University of Bordeaux, Bordeaux, France
| | - Nathalie de Rekeneire
- INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.,School of Public Health (ISPED), University of Bordeaux, Bordeaux, France
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15
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Ahangari A, Stewart Williams J, Myléus A. Pain and alcohol consumption among older adults: findings from the World Health Organization Study on global AGEing and adult health, Wave 1. Trop Med Int Health 2016; 21:1282-1292. [PMID: 27443945 DOI: 10.1111/tmi.12757] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate cross-sectional associations between self-reported recent pain and alcohol use/abstinence, and previous-day pain and previous-week alcohol consumption in adults aged 50 + in six low- and middle-income countries (LMICs). METHODS The WHO Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010) in China, Ghana, India, Mexico, Russia and South Africa is the data source. Prevalence of alcohol use/abstinence is reported by previous-day and previous-month pain. Multinomial logistic regressions (crude and adjusted for sex and country) tested associations between recent pain and alcohol use in the pooled multicountry sample. RESULTS Across the six SAGE countries, about one-third of respondents reported alcohol use, being highest in Russia (74%) and lowest in India (16%). Holding the effects of sex and country constant, compared with abstainers, people with previous-day pain were more likely to be previous-day or other users. With regard to the quantity and frequency of alcohol use, people with previous-day pain were more likely to be non-heavy drinkers. CONCLUSION Overall, we found that, in this population of older adults in six LMICs, recent pain was associated with moderate use of alcohol, although there were differences between countries. The findings provide a platform for country-specific research to better understand bi-directional associations between pain and alcohol in older adults.
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Affiliation(s)
- Alebtekin Ahangari
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Jennifer Stewart Williams
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden. .,Research Centre for Generational, Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
| | - Anna Myléus
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
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16
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van den Berg TJ, (René) van Rijn L, Kaper-Bongers R, Vonhoff D, Völker-Dieben H, Grabner G, Nischler C, Emesz M, Wilhelm H, Gamer D, Schuster A, Franssen L, de Wit G, Coppens J. Disability Glare in the Aging Eye. Assessment and Impact on Driving ☆. J Optom 2009. [PMCID: PMC3972772 DOI: 10.3921/joptom.2009.112] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Purpose To compare different methods for the assessment of disability glare sensitivity in the elderly, to arrive at an objective assessment of the condition of the eye. To delineate the importance of straylight values in vision. Methods Three groups of subjects were studied: 1) Young subjects without any eye disease, 2) elderly subjects without any eye disease and 3) elderly subjects with (early) cataract in at least one eye. All subjects underwent 2 glare tests, 2 straylight tests, ETDRS visual acuity test, Pelli Robson contrast sensitivity test, refraction, LOCS III cataract classification. Straylight was quantified by means of the straylight parameter s. Results Repeatability, discriminative ability, and added value as compared to visual acuity were low for the glare tests and good for the straylight measurements. For young normal subjects, with log(s)=0.9, the standard glare situation with low beams gives a contrast reduction of 1.3, whereas for the healthy 77 year olds this increases to 2. With cataract hardly affecting visual acuity, log(s) can be as high as 1.8, resulting in a contrast reduction of 3.4. Conclusion Straylight measurement is of relevance for the assessment of the glare-related hindrance during driving, and can be used to objectify complaints and aid in the decision-making regarding cataract surgery.
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Affiliation(s)
- Thomas J.T.P. van den Berg
- Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences. Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
- Corresponding author: Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.
| | | | - R. Kaper-Bongers
- From the The Free University Ophthalmology Dept., Amsterdam, the Netherlands
| | - D.J. Vonhoff
- From the The Free University Ophthalmology Dept., Amsterdam, the Netherlands
| | - H.J. Völker-Dieben
- From the The Free University Ophthalmology Dept., Amsterdam, the Netherlands
| | - G. Grabner
- From the Universitätsklinik für Augenheilkunde und Optometrie der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria
| | - C. Nischler
- From the Universitätsklinik für Augenheilkunde und Optometrie der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria
| | - M. Emesz
- From the Universitätsklinik für Augenheilkunde und Optometrie der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria
| | - H. Wilhelm
- From the Universitäts-Augenklinik, Tübingen, Germany
| | - D. Gamer
- From the Universitäts-Augenklinik, Tübingen, Germany
| | - A. Schuster
- From the Universitäts-Augenklinik, Tübingen, Germany
| | - L. Franssen
- Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences. Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - G.C. de Wit
- Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences. Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
| | - J.E. Coppens
- Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences. Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
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17
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King EC, McKay SM, Lee TA, Scovil CY, Peters AL, Maki BE. Gaze Behavior of Older Adults in Responding to Unexpected Loss of Balance while Walking in an Unfamiliar Environment: a Pilot Study. J Optom 2009; 2:119-126. [PMCID: PMC3972777 DOI: 10.3921/joptom.2009.119] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2009] [Revised: 07/29/2009] [Accepted: 08/05/2009] [Indexed: 05/31/2023]
Abstract
Purpose Rapid reach-to-grasp balance-recovery reactions play a critical role in preventing falls. Recent young-adult studies suggest these reactions may be guided using stored visuo-spatial information from the central field, and that peripheral vision may also play an important role. This study used gaze recordings to examine the visual control of reach-to-grasp reactions in older adults. Methods A motion platform was configured to simulate a “real-life” environment that included a handrail. Subjects performed an activity that required walking to the end of the platform, which was triggered to move suddenly and unexpectedly as they approached the handrail. Twelve healthy older adults (64-79 years old) were tested and compared to 12 healthy young adults (22-30 years old) tested as part of another study. Results Older adults were more than twice as likely as young adults to react to the platform perturbation by grasping the handrail (10/12 versus 4/12), despite being much less likely to visually fixate the handrail after entering the new environment. Grasping errors were remarkably common (5/10 older, 2/4 young), but there was no consistent relationship to the preceding gaze behavior. Conclusion Older adults were highly dependent on using a handrail to recover balance, but commonly failed to direct overt visual attention to the rail after entering the unfamiliar environment. The failure to fixate the rail required the reaching movement to be guided using peripheral vision. Further research is needed to determine whether grasping errors can be prevented via interventions that either attract overt attention to the handrail or improve processing of peripheral-field information.
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Affiliation(s)
- Emily C. King
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
- Institute of Biomaterials and Biomedical Engineering
| | - Sandra M. McKay
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
| | - Tracy A. Lee
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
| | - Carol Y. Scovil
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
| | - Amy L. Peters
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
| | - Brian E. Maki
- Centre for Studies in Aging, Sunnybrook Health Sciences Centre
- Institute of Biomaterials and Biomedical Engineering
- Institute of Medical Science, University of Toronto
- Department of Surgery, University of Toronto
- Toronto Rehabilitation Institute
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18
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Swanson MW, McGwin G, Elliott AF, Owsley C. Association between the Nursing Home Minimum Data Set for Vision and Vision-Targeted Health-Related Quality of Life in Nursing Home Residents As Assessed by Certified Nursing Assistants. J Optom 2009; 2:148-154. [PMID: 21331148 PMCID: PMC3039486 DOI: 10.3921/joptom.2009.148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 08/05/2009] [Accepted: 08/06/2009] [Indexed: 05/30/2023]
Abstract
PURPOSE: The purpose of this study was to evaluate the association between the federally mandated Minimum Data Set (MDS) Vision Patterns assessment for nursing home residents in the United States and an assessment of their vision-targeted quality of life as assessed by certified nursing assistants (CNAs). METHODS: Participants were 371 residents over the age of 55 from 17 nursing homes in the Birmingham, Alabama metropolitan area and the CNAs directly assigned to their care. CNAs assessed the vision-targeted quality of life of residents in their charge using the Nursing Home Vision-Targeted Health-Related Quality of Life (NHVQoL) questionnaire. MDS assessment categories assigned to each resident by the MDS nurse coordinator ("adequate", "impaired", "moderately impaired", "highly impaired", "severely impaired") were obtained from the medical record. Visual acuity was measured using logMAR charts by trained research staff. RESULTS: CNA rated NHVQoL subscale scores decreased as the MDS rating indicated more vision impairment (all P's for trend < 0.05). Almost all mean scores were in the 80s and 90s for those in the adequate, impaired, and moderately impaired categories. For those with MDS ratings of severely or highly impaired, NHVQoL subscale scores (except ocular symptoms) were dramatically lower (P ≤ 0.001) than those rated as moderately impaired. CONCLUSIONS: Ratings by CNAs on the vision-targeted quality of life of nursing home residents under their care is in general agreement with the MDS category assigned by the nurse coordinator. However, CNA ratings are largely homogeneous in the adequate vision to moderately impaired categories.
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Affiliation(s)
- Mark W. Swanson
- Department of Optometry, School of Optometry, University of Alabama at Birmingham
| | - Gerald McGwin
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Amanda F. Elliott
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
| | - Cynthia Owsley
- Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham
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19
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Zunzunegui Pastor MV, Rodríguez-Laso A, García de Yébenes MJ, Aguilar Conesa MD, Lázaro y de Mercado P, Otero Puime A. [Prevalence of urinary incontinence and linked factors in men and women over 65]. Aten Primaria 2003; 32:337-42. [PMID: 14572396 PMCID: PMC7684346 DOI: 10.1016/s0212-6567(03)79293-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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: 02/17/2003] [Accepted: 03/12/2003] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To calculate the prevalence of urinary incontinence and to identify linked factors in a population of elderly people living in their homes. DESIGN Population survey. SETTING Leganés (Madrid). PARTICIPANTS Representative sample of people over 65 registered in Leganés (n=1560). Two interviews at home were conducted. The second interview included a medical examination. The reply rate was 75% (n=1150). MAIN MEASUREMENTS Frequency of involuntary losses of urine and use of medication and absorbents, health status, use of diuretics and oxybutinin, and demographic and social variables. RESULTS The prevalence of urinary incontinence was 14% (95% CI, 11%-17%) in men and 30% (95% CI, 26%-34%) in women. Advanced age was associated with greater prevalence in men but not in women. In the multivariate analysis, factors associated with urinary incontinence were comorbidity and cognitive deficit. In addition, in women, high Body Mass Index and seriously limited movement were added factors. 20% of women and 5% of men over 65 used absorbents. The use of diuretics and the low number of patients receiving specific treatment for urinary incontinence suggested that there was low detection of this problem. CONCLUSIONS Urinary incontinence is common and could be better detected and treated in primary care. Prevention of urinary incontinence in women should begin before old age.
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20
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Redondo-Martínez M, Salcedo-Aguilar F, García-Jiménez M, Monterde-Aznar M, Rodríguez-Almonacid F, Marcos-Navarro A. [Prevalence of insomnia and use of psychodrugs among elderly in a basic health area in Cuenca]. Aten Primaria 2000; 25:400-4. [PMID: 10857230 PMCID: PMC7675832 DOI: 10.1016/s0212-6567(00)78530-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Insomnia is the most common sleeping disorder, increasing as people get older, which therefore creates an increase in the use of hypnotics. The presence of insomnia in elderly people, according to different authors, ranges between 17 and 43% depending on the criteria of diagnosis used and the group of population studied. The objectives of this study are to determine the prevalence of insomnia in a population of 65 years and over in a Basic Health Area and the medical consumption related to it. DESIGN A cross sectional study by means of an ad hoc questionnaire about sleeping habits given by medical staff, including social demographic variables, psychotropic medication consumption, cognitive assessment by means of Mini Mental Status Examination and a range of anxiety-depression of Goldberg. Hartman and DSM-IV criteria were used for the insomnia diagnosis. SETTING Cuenca I Primary Care Center, Cuenca (Spain). PATIENTS A random sample of 343 patients of a population of 2253, 65 years and over. MEASUREMENTS AND MAIN RESULTS The prevalence found was 13.6% (Hartman) and 30.7% (DSM-IV) more common amongst women (p < 0.005), sufferers of psychiatric illnesses (p < 0.01) and those at the top-half of the anxiety-depression scale (p < 0.001). A 46.1% suffer from daylight hypersomniac. A 19.1% takes some kind of medication to help them sleep and the 74.6% of them take it daily. Long and short plasma half-life benzodiazepines are the most consumed, with women and insomniacs being the majority consumers. CONCLUSIONS The prevalence of insomnia in our population is slightly inferior to that of other studies and the consumption of sleep-enhancing medication although inappropriate is similar to that referred to in literature.
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Affiliation(s)
- M.P. Redondo-Martínez
- Unidad Docente de Medicina de Familia y Comunitaria. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
| | - F. Salcedo-Aguilar
- Unidad Docente de Medicina de Familia y Comunitaria. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
- Correspondencia: Unidad Docente de Medicina de Familia y Comunitaria. Parque San Fernando, s/n. 16004 Cuenca.
| | - M.A. García-Jiménez
- Servicio de Neurofisiología Clínica. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
| | - M.L. Monterde-Aznar
- Unidad Docente de Medicina de Familia y Comunitaria. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
| | - F.M. Rodríguez-Almonacid
- Unidad Docente de Medicina de Familia y Comunitaria. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
| | - A.I. Marcos-Navarro
- Unidad Docente de Medicina de Familia y Comunitaria. Unidad Docente de Medicina de Familia y Comunitaria y Hospital Virgen de la Luz. Cuenca
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