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Caballero-Mora MA, Rodríguez Mañas L, Valdés-Aragonés M, García-Sánchez I, Alonso-Bouzon C, Castro Rodríguez M, Nuñez-Jimenez L, Esteban A, Rodriguez-Laso A. Factors associated with impairment in gait speed in older people with clinically normal gait. A cross-sectional study. Aging Clin Exp Res 2020; 32:1043-1048. [PMID: 30989508 DOI: 10.1007/s40520-019-01187-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Health professionals commonly use gait speed in the evaluation of functional status in older people. However, only a limited number of studies have assessed gait speed in the absence of disorders of gait, using confounding factors and exclusion criteria coming from studies conducted in younger people. Our study aims to analyse which factors are associated with gait speed in older people with normal clinical gait. METHODS An observational cross-sectional study was conducted in 119 community-dwelling residents without relevant comorbidities (Charlson index < 2), preserved function (Barthel > 85) and normal gait by visual exploration. Exclusion criteria included suffering from any illness that could modify the characteristics of gait, terminal status or the presence of an acute medical illness in the past 3 months. We used a stepwise linear regression of several variables (sociodemographic characteristics, cognition, body composition, drugs, falls, sarcopenia, frailty and physical activity) on 6-metre gait speed. RESULTS The mean age was 78 years (range 70-96 years) and 71.4% were women. Variables that remained associated with gait speed in the multivariate final model were age (B = - 0.020, p < 0.001); gender (B = - 0.184, p < 0.001); waist-to-height ratio (B = - 0.834, p = 0.002); number of falls (B = - 0.049, p = 0.003) and the number of Fried's frailty criteria (B = - 0.064, p = 0.019). CONCLUSION Falls, frailty and the waist-to-height ratio modify gait speed in older people with normal gait. Studies analysing the potential effect of several factors on gait speed should consider them as confounding factors.
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Affiliation(s)
- M A Caballero-Mora
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain.
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain.
- CIBER de Fragilidad y Envejecimiento Saludable, Madrid, Spain.
| | - L Rodríguez Mañas
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
- CIBER de Fragilidad y Envejecimiento Saludable, Madrid, Spain
| | - M Valdés-Aragonés
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | - I García-Sánchez
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain
| | - C Alonso-Bouzon
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - M Castro Rodríguez
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - L Nuñez-Jimenez
- Servicio de Geriatría, Geriatric Department, Hospital Universitario de Getafe, Ctra de Toledo Km 12.5, 28905, Getafe, Spain
| | - A Esteban
- CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - A Rodriguez-Laso
- Fundación de Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain.
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Prieto-Alhambra D, Moral-Cuesta D, Palmer A, Aguado-Maestro I, Bardaji MFB, Brañas F, Bueno GA, Caeiro-Rey JR, Cano IA, Barres-Carsi M, Delgado LG, Salomó-Domènech M, Etxebarria-Foronda I, Ferrer BL, Mills S, Herrando LE, Mifsut D, Evangelista LDR, Nogués X, Perez-Coto I, Blasco JMI, Martín-Hernández C, Kessel H, Serra JT, Solis JR, Suau OT, Vaquero-Cervino E, Hernández CP, Mañas LR, Herrera A, Díez-Perez A. The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study. Arch Osteoporos 2019; 14:56. [PMID: 31144117 PMCID: PMC6541580 DOI: 10.1007/s11657-019-0607-0] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 05/13/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE The medical morbidity and mortality associated with neck of femur fractures is well-documented, whereas there is limited data for patient-reported outcomes. The aim of this study was to characterize the impact of neck of femur fractures on activities of daily living and patient-reported health-related quality of life. METHODS Design and participants: Multicentric prospective cohort study. Consecutive sample patients with fragility hip fracture over 50 years old admitted in 48 hospitals in Spain. OUTCOMES daily living activity function (Barthel Index) and health-related quality of life (EQ-5D) pre-fracture, admission to hospital and at 1- and 4-month follow-up post-fracture. STATISTICS Barthel and EQ-5D over time are described as mean (SD) and median (interquartile range). RESULTS A total of 997 patients were recruited at baseline with 4-month outcomes available for, and 856 patients (89.5%). Barthel Index fell from 78.77 (23.75) at baseline to 43.62 (19.86) on admission to hospital with the fracture. Scores partially recovered to 54.89 (25.40) and 64.09 (21.35) at 1- and 4-month post-fracture, respectively. EQ-5D fell from a median of 0.75 (0.47-0.91) to - 0.01 (- 0.03 to 0.51) on admission. Partial recovery was observed again to (0.51 (- 0.06 to 0.67)) and (0.60 (0.10 to 0.80)) at 1- and 4-month post-fracture, respectively. CONCLUSIONS Hip fracture results in a large decline in the ability to perform activities of daily living and patient-reported health-related quality of life with only partial recovery amongst survivors 4-month post-fracture.
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Affiliation(s)
- D. Prieto-Alhambra
- grid.452479.9GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l’Aparell Locomotor) Research Group, CIBERFES, IDIAP Jordi Gol (Universitat Autònoma de Barcelona) and Instituto de Salud Carlos III, Av Gran Via de les Corts Catalanes, 587, Atic, 08007 Barcelona, Spain ,0000 0004 1936 8948grid.4991.5Musculoskeletal Pharmaco and Device Epidemiology - Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD UK ,grid.7080.fMusculoskeletal Research Unit, IMIM-Parc Salut Mar, CIBERFES, Universitat Autònoma de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - D. Moral-Cuesta
- 0000 0000 8970 9163grid.81821.32Geriatric Unit, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - A. Palmer
- Traumatology and Orthopaedics Unit, Nuffield Orthopedic Centre, Windmill Rd, Headington, Oxford, OX3 7HE UK
| | - I. Aguado-Maestro
- 0000 0001 1842 3755grid.411280.eHospital Universitario Rio Hortega, Calle Dulzaina, 2, 47012 Valladolid, Spain
| | - M. F. Bravo Bardaji
- grid.411457.2Hospital Regional Universitario de Malaga, Av. de Carlos Haya, s/n, 29010 Málaga, Spain
| | - F. Brañas
- grid.414761.1Geriatric Unit, Hospital Universitario Infanta Leonor, Gran Vía del Este, 80, 28031 Madrid, Spain
| | - G. Adrados Bueno
- 0000 0004 1771 0842grid.411319.fInternal Medicine Unit, Hospital Infanta Cristina, Av. de Elvas, s/n, 06080 Badajoz, Spain
| | - J. R. Caeiro-Rey
- 0000 0000 8816 6945grid.411048.8Traumatology and Orthopaedics Unit, Complejo Hospitalario Universitario de Santiago de Compostela, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña Spain
| | - I. Andrés Cano
- 0000 0004 1771 1175grid.411342.1Hospital Puerta del Mar, Av. Ana de Viya, 21, 11009 Cádiz, Spain
| | - M. Barres-Carsi
- 0000 0001 0360 9602grid.84393.35Hospital Universitari i Politècnic La Fe, Av de Fernando Abril Martorell, 106, 46026 València, Spain
| | - L. Gracia Delgado
- 0000 0004 1771 4667grid.411349.aHospital Universitario Reina Sofía de Cordoba, Av Menendez Pidal, 14004 Córdoba, Spain
| | - M. Salomó-Domènech
- 0000 0000 9238 6887grid.428313.fCorporación sanitaria Universitaria Parc Tauli, Parc Taulí, 1, 08208 Sabadell, Barcelona Spain
| | | | - B. Llado Ferrer
- grid.413457.0Hospital Son Llàtzer, Carretera de Manacor, PQ 4 (Son Ferriol), 07198 Palma de Mallorca, Spain
| | - S. Mills
- 0000 0000 8970 9163grid.81821.32Traumatology and Orthopaedics Unit, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - L. Ezquerra Herrando
- 0000 0004 1767 4212grid.411050.1F.E.A of the Traumatology and Orthopaedics Unit, Hospital Clínico Universitario Lozano Blesa, Av. San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - D. Mifsut
- grid.411308.fHospital Clínico de Valencia, Av de Blasco Ibáñez, 17, 46010 Valencia, Spain
| | - L. D. R. Evangelista
- 0000 0001 0635 4617grid.411361.0Geriatric Unit, Hospital Universitario Severo Ochoa, Av. De Orellana s/n, 28911 Leganés, Madrid Spain
| | - X. Nogués
- grid.7080.fInternal Medicine Department IMIM (Hospital del Mar Medical Research), CIBER FES ISCIII, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - I. Perez-Coto
- Hospital Universitario San Agustín, Camino de Heros, 6, 33401 Avilés, Asturias Spain
| | | | - C. Martín-Hernández
- 0000 0000 9854 2756grid.411106.3IIS Aragón (Instituto de Investigación Sanitaria de Aragón), Hospital Universitario Miguel Servet, Paseo Isabel la Católica 1-3, 50009 Zaragoza, Spain
| | - H. Kessel
- 0000 0000 9832 1443grid.413486.cGeriatric Care Unit, Complejo Hospitalario Torrecárdenas, Calle Hermandad de Donantes de Sangre, 04009 Almería, Spain
| | - J. Teixidor Serra
- 0000 0001 0675 8654grid.411083.fHospital Universitari Vall de Hebron, Passeig de la Vall d’Hebron, 119-129, 08035 Barcelona, Spain
| | - J. Rodriguez Solis
- grid.411098.5Geriatric Unit, Hospital Universitario de Guadalajara, Calle Donante de Sangre, s/n, 19002 Guadalajara, Spain
| | - O. Torregrosa Suau
- 0000 0004 0399 7977grid.411093.eBone Metabolism Unit, Internal Medicine Unit, Hospital General Universitari d’Elx, Carrer Almazara, 11, 03203 Elche, Alicante Spain
| | - E. Vaquero-Cervino
- 0000 0000 8490 7830grid.418886.bComplejo Hospitalario de Pontevedra, Av Montecelo, 0, 36164, Casas Novas, Pontevedra, Spain
| | - C. Pablos Hernández
- grid.411258.bGeriatric Unit, Hospital de Salamanca, Paseo de San Vicente, 139, 37007 Salamanca, Spain
| | - L. Rodríguez Mañas
- 0000 0000 9691 6072grid.411244.6Geriatric Unit, Hospital Universitario de Getafe, Carr. De Madrid - Toledo, Km 12,500, 28905 Getafe, Madrid Spain
| | - A. Herrera
- 0000 0001 2152 8769grid.11205.37Department of Surgery, Aragón Health Research Institute, University of Zaragoza, Zaragoza, Spain
| | - A. Díez-Perez
- grid.7080.fMusculoskeletal Research Unit, IMIM-Parc Salut Mar, CIBERFES, Universitat Autònoma de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain
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Gómez-Huelgas R, Gómez Peralta F, Rodríguez Mañas L, Formiga F, Puig Domingo M, Mediavilla Bravo JJ, Miranda C, Ena J. [Treatment of type 2 diabetes mellitus in elderly patients]. Rev Esp Geriatr Gerontol 2018; 53:89-99. [PMID: 29439834 DOI: 10.1016/j.regg.2017.12.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 12/18/2017] [Indexed: 06/08/2023]
Abstract
The prevalence of type 2 diabetes mellitus (DM2) increases markedly with age. Antidiabetic treatment and the objectives of glycaemic control in elderly patients with DM2 should be individualised according to their biopsychosocial characteristics. In elderly patients for whom the benefits of intensive antidiabetic treatment are limited, the basic objectives should be to improve the quality of life, preserve functionality and avoid adverse effects, especially hypoglycaemia. Treatment of DM2 in the elderly was the subject of a consensus document published in 2012 and endorsed by several Spanish scientific societies. Since then, new therapeutic groups and evidence have emerged that warrant an update to this consensus document. The present document focuses on the therapeutic aspects of DM2 in elderly patients, understood as being older than 75 years or frail.
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Affiliation(s)
- R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA); CIBER de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III; Sociedad Española de Medicina Interna (SEMI).
| | - F Gómez Peralta
- Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, España; Sociedad Española de Diabetes (SED)
| | - L Rodríguez Mañas
- Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III; Sociedad Española de Medicina Geriátrica (SEMEG)
| | - F Formiga
- Unidad de Geriatría, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Sociedad Española de Geriatría y Gerontología (SEGG)
| | - M Puig Domingo
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III; Sociedad Española de Endocrinología y Nutrición (SEEN)
| | - J J Mediavilla Bravo
- Centro de Salud Burgos Rural, Burgos, España; Sociedad Española de Medicina General (SEMERGEN)
| | - C Miranda
- Centro de Salud Buenavista, Toledo, España; Sociedad Española de Médicos Generales y de Familia (SEMG)
| | - J Ena
- Servicio de Medicina Interna, Hospital Marina Baixa, La Vila Joiosa, Alicante, España; Sociedad Española de Medicina Interna (SEMI)
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4
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Gómez-Huelgas R, Gómez Peralta F, Rodríguez Mañas L, Formiga F, Puig Domingo M, Mediavilla Bravo JJ, Miranda C, Ena J. Treatment of type 2 diabetes mellitus in elderly patients. Rev Clin Esp 2018; 218:74-88. [PMID: 29366502 DOI: 10.1016/j.rce.2017.12.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 10/11/2017] [Accepted: 12/03/2017] [Indexed: 02/06/2023]
Abstract
The prevalence of type 2 diabetes mellitus (DM2) increases markedly with age. Antidiabetic treatment and the objectives of glycaemic control in elderly patients with DM2 should be individualised according to their biopsychosocial characteristics. In elderly patients for whom the benefits of intensive antidiabetic treatment are limited, the basic objectives should be to improve the quality of life, preserve functionality and avoid adverse effects, especially hypoglycaemia. Treatment of DM2 in the elderly was the subject of a consensus document published in 2012 and endorsed by several Spanish scientific societies. Since then, new therapeutic groups and evidence have emerged that warrant an update to this consensus document. The present document focuses on the therapeutic aspects of DM2 in elderly patients, understood as being older than 75 years or frail.
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Affiliation(s)
- R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA); CIBER de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III; Sociedad Española de Medicina Interna (SEMI).
| | - F Gómez Peralta
- Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, España; Sociedad Española de Diabetes (SED)
| | - L Rodríguez Mañas
- Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III; Sociedad Española de Medicina Geriátrica (SEMEG)
| | - F Formiga
- Unidad de Geriatría, Hospital Universitari de Bellvitge, ĹHospitalet de Llobregat, Barcelona, España; Sociedad Española de Geriatría y Gerontología (SEGG)
| | - M Puig Domingo
- Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III; Sociedad Española de Endocrinología y Nutrición (SEEN)
| | - J J Mediavilla Bravo
- Centro de Salud Burgos Rural, Burgos, España; Sociedad Española de Medicina General (SEMERGEN)
| | - C Miranda
- Centro de Salud Buenavista, Toledo, España; Sociedad Española de Médicos Generales y de Familia (SEMG)
| | - J Ena
- Servicio de Medicina Interna, Hospital Marina Baixa, La Vila Joiosa, Alicante, España; Sociedad Española de Medicina Interna (SEMI)
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Rodríguez Mañas L, García-Sánchez I, Hendry A, Bernabei R, Roller-Wirnsberger R, Gabrovec B, Liew A, Carriazo AM, Redon J, Galluzzo L, Viña J, Antoniadou E, Targowski T, Di Furia L, Lattanzio F, Bozdog E, Telo M. Key Messages for a Frailty Prevention and Management Policy in Europe from the ADVANTAGE JOINT ACTION Consortium. J Nutr Health Aging 2018; 22:892-897. [PMID: 30272089 DOI: 10.1007/s12603-018-1064-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Indexed: 01/10/2023]
Abstract
In the 2015 Ageing Report, the European Commission (EC) and the Economic Policy Committee stated that coping with the challenge posed by an ageing population will require determined policy action in Europe, particularly in reforming pension, health care and long-term care systems. The concern for this situation motivated the EC, the Parliament and many of the Member States (MS) to co-fund, in the 2015 call of the Third European Health Programme of the European Union 2014-2020, the first Joint Action (JA) on the prevention of frailty. ADVANTAGE JA brings together 33 partners from 22 MSs for 3 years. It aims to build a common understanding on frailty to be used in the MSs by policy makers and other stakeholders involved in the management, both at individual and population level, of older people who are frail or at risk for developing frailty throughout the European Union (EU). It is a formidable challenge but also a great opportunity for concerted action resulting in fostering effective and successful policies in frailty prevention and management in the participating MS. The Consortium has 2 years of hard work ahead to contribute to the needed change for frailty related disability free Europe. The first practical step towards this aim was the preparation of a document: the State of the Art on Frailty Report to support an overview of evidence of what works and what does not work on frailty prevention and management. Subsequently, this will be reflected in the advice that the JA will give to policy makers at MS level. Overall, these messages intend to be an instrument of added value to advocate for policy driven decisions on frailty prevention and management in the JA participating MSs and subsequently towards a frailty related disability free older population in Europe. The aim of this paper is to describe ADVANTAGE JA general structure, approach and recommendations towards a European health and social policy which will support frailty prevention in the participating MS.
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6
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Gomis R, Mata Cases M, Mauricio Puente D, Artola Menéndez S, Ena Muñoz J, Mediavilla Bravo JJ, Miranda Fernández-Santos C, Orozco Beltrán D, Rodríguez Mañas L, Sánchez Villalba C, Martínez JA. [Methodological aspects of integrated care pathways]. ACTA ACUST UNITED AC 2017; 32:234-239. [PMID: 28283260 DOI: 10.1016/j.cali.2016.12.003] [Citation(s) in RCA: 5] [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: 09/16/2016] [Revised: 11/18/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
An Integrated Healthcare Pathway (PAI) is a tool which has as its aim to increase the effectiveness of clinical performance through greater coordination and to ensure continuity of care. PAI places the patient as the central focus of the organisation of health services. It is defined as the set of activities carried out by the health care providers in order to increase the level of health and satisfaction of the population receiving services. The development of a PAI requires the analysis of the flow of activities, the inter-relationships between professionals and care teams, and patient expectations. The methodology for the development of a PAI is presented and discussed in this article, as well as the success factors for its definition and its effective implementation. It also explains, as an example, the recent PAI for Hypoglycaemia in patients with Type 2 Diabetes Mellitus developed by a multidisciplinary team and supported by several scientific societies.
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Affiliation(s)
- R Gomis
- Sociedad Española de Diabetes (SED), Barcelona, España.
| | - M Mata Cases
- Sociedad Española de Diabetes (SED), Barcelona, España
| | - D Mauricio Puente
- Sociedad Española de Endocrinología y Nutrición (SEEN), Barcelona, España
| | - S Artola Menéndez
- Fundación Red de Grupos de Estudio de la Diabetes en Atención Primaria de la Salud (RedGDPS), Madrid, España
| | - J Ena Muñoz
- Sociedad Española de Medicina Interna (SEMI), Alicante, España
| | | | | | - D Orozco Beltrán
- Sociedad Española de Medicina de Familia y Comunitaria (SemFYC), Alicante, España
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7
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Lobo A, Dewey M, López Antón R, Lobo E, Modrego P, Rodríguez Mañas L. Reply: To PMID 24893954. Acta Psychiatr Scand 2015; 132:81-2. [PMID: 25703044 DOI: 10.1111/acps.12405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Lobo
- Centro de Investigación, Biom,edica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain. .,Department of Medicine and Psychiatry, IIS - Aragon, Universidad de Zaragoza, Zaragoza, Spain.
| | - M Dewey
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - R López Antón
- Centro de Investigación, Biom,edica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Psychology and Sociology, IIS - Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - E Lobo
- Centro de Investigación, Biom,edica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain
| | - P Modrego
- Department of Medicine and Psychiatry, IIS - Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - L Rodríguez Mañas
- Hospital Universitario de Getafe and Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), Madrid, Spain
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El Assar M, Alonso C, Rodríguez Mañas L. Complementariness of experimental approaches to address research questions in older people. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2014.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Marín Iranzo R, Tranche Iparraguirre S, Armengol Bertolín S, Rodríguez Mañas L, Abellán Alemán J, Aranda Lara P, Calvo Gómez C, Coca Payeras A. Eficacia y tolerabilidad de irbesartán en pacientes con hipertensión arterial y diabetes mellitus tipo 2. Hipertensión y Riesgo Vascular 2003. [DOI: 10.1016/s1889-1837(03)71397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marín R, Coca A, Tranche S, Rodríguez Mañas L, Abellán J, Moyá A. [Prevalence of renal involvement in a population of type Ii diabetics followed up in primary care]. Nefrologia 2002; 22:152-61. [PMID: 12085416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
UNLABELLED Patients with type 2 diabetes use to be managed in their primary care settings during the early stages of the disease. The main objective of the study was to determine renal impairment prevalence, and to assess its significance, within type 2 diabetics controlled by their family physicians. PATIENTS AND METHOD Transverse observation of patients with type 2 diabetes who were the first 20 unselected cases seen by 183 family physicians from 16 of the 17 Autonomic Communities of our country. The following variables were determined: serum creatinine, glucose, and HbA1c concentrations, proteinuria (dipstick test in a first-voided morning urine sample), blood pressure levels, and associated cardiovascular disease. RESULTS Data from 3,583 type 2 diabetic subjects were evaluated. Mean age was 64 +/- 10 years and 45% were male. A serum creatinine > or = 1.2 mg/dl was observed in 523 (15.5%) patients. Proteinuria was present in 794 (23.5%) cases, being > or = 2 + in 215 (6.5%) subjects. Patients with a serum creatinine > or = 1.2 mg/dl were older, shower higher blood pressure levels, and suffered from more cardiovascular disease (32.0 vs 19.5%) than those with a serum creatinine < 1.2 mg/dl. In a multivariate analysis, this difference continued to be significant (OR 1.47; 95% CI 1.14 to 1.90; p = 0.002. Patients with proteinuria showed a higher prevalence of cardiovascular disease (OR 1.83; 95% CI 1.47 to 2.27; p < 0.0001) than those without proteinuria. This association was continuous through no proteinuria to the > or = 2 + proteinuria (p < 0.001). Blood pressure level was > or = 140/90 mmHg in 69% of the cases, being < 130/85 mmHg in only 8% of the subjects. CONCLUSIONS There is a high prevalence of renal impairment, approximately of 25% within type 2 diabetic patients seen at the primary care level. Optimal blood pressure level seems to be extremely infrequent bearing in mind the diagnosis of diabetes and the associated cardiovascular disease.
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Affiliation(s)
- R Marín
- Servicio de Nefrología, Unidad de Hipertensión, Hospital Covadonga, Oviedo.
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Ortega RM, Mañas LR, Andrés P, Gaspar MJ, Agudo FR, Jiménez A, Pascual T. Functional and psychic deterioration in elderly people may be aggravated by folate deficiency. J Nutr 1996; 126:1992-9. [PMID: 8759371 DOI: 10.1093/jn/126.8.1992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The deterioration of functional and mental capacity is one of the major problems of the elderly. This deterioration may be caused or worsened by folate deficiency. The aim of this investigation was to analyze the relationship between mental and functional capacities and folate status in a group of 177 elderly Spanish people. Folate deficiency is common in the Spanish population. In this study, 48.6% of the elderly subjects had folate intakes below recommended values (200 microg/day), 34.9% had serum concentrations < 14 nmol/L and 6.6% had <360 nmol/L erythrocyte folate. Subjects took part in a series of tests: Katz' scale of activities of daily living, Lawton's scale of instrumental activities of daily living, Pfeiffer's mental status questionnaire, Folstein's Mini-Mental State Test and the Geriatric Depression scale of Yesavage. The results for Lawton's scale of instrumental activities of daily living were significantly better (indicating greater independence and capacity) when folate intake and serum or erythrocyte folate concentrations were adequate (i.e., folate intake no less than recommended, > or = 14 nmol/L serum folate or > or = 360 nmol/L erythrocyte folate). Subjects with adequate Mini-Mental State Exam results (> or = 28 points) had serum and erythrocyte folate concentrations significantly higher than those with less adequate results (<28 points). Thus, there is evidence to suggest that the folate status of the elderly should be monitored and, if possible, improved.
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Affiliation(s)
- R M Ortega
- Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense, 28040-Madrid, Spain
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González Montalvo JI, Pérez del Molino J, Rodríguez Mañas L, Salgado Alba A, Guillén Llera F. [Geriatrics and geriatric care: for whom and how (and II)]. Med Clin (Barc) 1991; 96:222-8. [PMID: 2041389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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González Montalvo JI, Pérez del Molino J, Rodríguez Mañas L, Salgado Alba A, Guillén Llera F. [Geriatrics and geriatric care: for whom and how (I)]. Med Clin (Barc) 1991; 96:183-8. [PMID: 2033990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Guillén Llera F, Caballero JC, Guijarro JL, Reuss JM, Rodríguez Mañas L, Sagués F, Sempere R, Tobares N, Vigueras S. [A multicenter study comparing nitrendipine and chlorthalidone in elderly hypertensive patients]. Rev Clin Esp 1990; 187:170-4. [PMID: 2091073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
One hundred and eleven low-moderate hypertense elderly patients treated with nitrenpidine or chlortalidone were studied during 4 months either on monotherapy or in combination according to the therapeutic response observed. The therapeutic goal (diastolic arterial pressure less than 95 mmHg) was obtained in 92.4% of patients on nintrenpidine and in 49.1% on chlortidone, both on monotherapy (2 months) (p less than 0.001). At the end of the study 96.3% of patients reaches the therapeutic goal. Secondary effects were observed in 8.3% of patients on nitrenpidine and 6.1% on chlortalidone and in 11.1% of patients on combined treatment. No abnormalities were observed in blood biochemistry studied nor was there evidence of a significant influence of any of the two drugs on the patients quality of life which was evaluated through a specific questionnaire specially designed.
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González Montalvo JI, Jaramillo Gómez E, Rodríguez Mañas L, Guillén Llera F, Salgado Alba A. [An evolutionary study of patients under geriatric home care at 18 months]. Rev Clin Esp 1990; 187:165-9. [PMID: 2091072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In this study we analyze the evolution of 85 patients included in a geriatric home care (GHC) program after 18 months. Mean age was 82 years, with a mean 4 diagnosis per patient and treatment with a mean of 3 drugs per patient. Of these patients 53% presented physical and 36% mental severe deterioration. After 18 months, 39% of the patients had died and 25% continued in the program. Readmissions at the geriatric ward was only 16% in the 18 months of follow-up. The most deteriorated patients required a greater nursery attention and less pharmacological treatment. Male patients presented more pluripathology, required more nurse techniques and died more frequently than females, who were more frequently discharged. These data contribute to the better knowledge of GHC, a care level which should be considered when planning health assistance of the elderly.
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Rodríguez Artalejo F, González Montalvo JI, Sanz Segovia F, Jaramillo Gómez E, Banegas Banegas JR, Rodríguez Mañas L, Carbonell Collar A. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital]. Med Clin (Barc) 1989; 93:411-4. [PMID: 2607799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.
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López Arrieta JM, Rodríguez Mañas L. [Osteogenesis imperfecta in an elderly patient]. Med Clin (Barc) 1987; 89:40-1. [PMID: 3613739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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