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Ferrer A.,Primary Health Care Center El Pla I | Formiga F.,Hospital Universitari Of Bellvitge | Formiga F.,Lohospitalet Of Llobregat | Plana-Ripoll O.,Idiap Research Institute | And 4 more authors.
Archives of Gerontology and Geriatrics | Year: 2012

Falls are a source of morbidity and mortality in the oldest old. The purpose of this study was to describe the prevalence of falls among community-dwelling 85-year-olds and to study the factors associated with falling. A cross-sectional study, including geriatric assessment, was conducted within the framework of the Octabaix Study. Functional status was measured with Barthel Index (BI) and Lawton Index (LI), cognitive impairment was assessed with the Mini-Mental State Examination (MMSE), the Spanish version of which is called MEC, Comorbidity by Charlson Index (CCI), and data were gathered on nutritional risk, social risk, falls, and drugs. The fall prevalence among the 328 octogenarians studied was 28.4%. A bivariate analysis revealed an association with being female (p= 0.017) and poorer functional status according to BI (p= 0.027). Logistic analysis showed an association with female gender (OR = 1.96; 95%CI = 1.15-3.33; p= 0.014), BI (OR = 0.98; 95%CI = 0.97-0.99; p= 0.007) and MEC (OR = 1.05; 95%CI = 1.01-1.09; p= 0.027). The prevalence of falls among 85-year-olds is high and similar to that described in those aged 65 or over. The analyses show that being female, a degree of disability and a good score on cognitive status were independent risk factors for falls among these community-dwelling. © 2011 Elsevier Ireland Ltd.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Padros G.,Lhospitalet Of Llobregat | Soto A.L.,Hospital Clinic Of Barcelona | And 3 more authors.
Aging Clinical and Experimental Research | Year: 2011

Background and aims: The presence of an immune-risk phenotype (IRP) has been correlated with survival rates in elderly people. The aim of this study is to characterize the inverted CD4:CD8 ratio as a possible marker of IRP in a sample of oldest old (85 years) by assessing differences in gender and health status. Methods: Comorbidity, functional status (Barthel Index), and cognitive status with the Spanish version of the Mini-Mental State Examination were evaluated. Non-disabled subjects were defined as those with better health status, with scores of >90 on the Barthel Index and >23 points on the Spanish version of the Mini-Mental State Examination. CD4:CD8 ratios were recorded, and a ratio of 1.00 or less was used to define IRF. Results: Three hundred and twelve subjects aged 85 years old were studied, 190 women (60.9%) and 122 men. The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%) and higher than 2.2 in 115 (36.8%). There were no differences in CD4:CD8 ratio according to health status. The inverted CD4:CD8 ratio was more frequent in men (55.3%). Conclusion: In this community-dwelling, single year birth cohort study, the subgroup with poor health status did not have a lower CD4:CD8 ratio. The inverted CD4:CD8 ratio was more frequent in men. ©2011, Editrice Kurtis.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Padros G.,Lhospitalet Of Llobregat | Contra A.,Hospital Universitari Of Bellvitge | And 3 more authors.
European Journal of Endocrinology | Year: 2014

Objective: Subclinical thyroid disorders are common in older individuals. Health risks associated with subclinical hypothyroidism in older adults are unclear. The aim of the study is to evaluate whether thyroid status in elderly subjects correlates with physical and cognitive function at baseline and with 3-year mortality. Design: A population-based, prospective cohort of the OCTABAIX study (307 inhabitants aged 85 years at baseline). Methods: Chronic drug prescription, functional status (Barthel and Lawton indices) and cognitive status according to the Spanish version of the Mini-Mental State Examination were recorded. Quality of life was assessed using the visual analogue scale of the quality of life test. Concentrations of TSH and thyroxine were measured. Participants were classified in accordance with clinical categories of thyroid function. Results: Twenty (6.5%) individuals had subclinical hypothyroidism and five (1.6%) had subclinical hyperthyroidism. Compared with euthyroid subjects (n=280; 91.8%), subclinical hypo- and hyperthyroidism subjects were not significantly associated with poor physical or cognitive function at baseline. Fifty-one (15.1%) subjects died during the 36 months of follow-up. TSH values and subclinical hypo- and hyperthyroidism were not associated with an increased overall mortality risk (hazard ratio (HR) 1.086, 95% CI 0.987-1.196 and HR 0.905, 95% CI 0.902-1.053 respectively). Conclusions: This study does not support the association of TSH or thyroid disorders with physical or cognitive function at baseline or with 3-year mortality in the oldest old subjects. © 2014 European Society of Endocrinology.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Rodriguez Molinero A.,Fundacio Hospital Comarcal Sant Antoni Abat | Fraga A.,Hospital Universitari Of Bellvitge | And 2 more authors.
Journal of Nutrition, Health and Aging | Year: 2011

Objectives: To evaluate vital status after five years of follow-up in a cohort of nonagenarians with functional and/or cognitive impairment at baseline. Design: Prospective cohort study. Setting: A community-based study. Participants: Nonagenarians enrolled in the NonaSantfeliu study. Measurements: Functional status was determined by the Lawton-Brody and Barthel indexes (BI), while cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC). Nonagenarians scoring up to 59 points on the BI were defined as individuals with significant functional impairment. Nonagenarians with cognitive decline were defined as those individuals with a score of 23 or less on the MEC. Subjects scoring <60 on the BI and <24 on the MEC were considered to show combined impairment (both functional and cognitive). Results: Sixty-three of 71 (88.8%) subjects with a BI <60 and 73 of 84 (86.9%) with a MEC score <24 had died after five years. Forty-eight of 53 nonagenarians (90%) with combined impairment died during the same follow-up period. A prior diagnosis of heart failure was the only variable associated with higher mortality in the three groups of subjects. Conclusion: Most of the nonagenarian subjects with functional and/or cognitive impairment at baseline had died at five-year follow-up © 2011 Serdi and Springer Verlag France.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Montero A.,Hospital Universitari Of Bellvitge | Chivite D.,Hospital Universitari Of Bellvitge | Pujol R.,Hospital Universitari Of Bellvitge
Journal of Nutrition, Health and Aging | Year: 2010

Objectives: To examine the survival rates of subjects aged 95 or over after a follow-up period of 3 years, and to determine predictive factors for mortality risk. Design: A prospective cohort study. Setting: A community-based study. Participants: Forty-eight subjects aged 95 or over. Measurements: Sociodemographic data, Barthel Index, Lawton-Brody Index, Spanish version of the Mini-Mental State Examination, short version of the Mini Nutritional Assessment, comorbidity (Charlson Index), and prevalent chronic diseases were evaluated. Patients who died were compared with the rest. Results: Thirty-six deaths (75%) were recorded during follow-up. The Cox multivariate analysis showed that lower Barthel Index scores and a history of heart failure were independently associated with long-term mortality. Conclusions: In subjects aged 95 or over, poor functional status and history of heart failure were the two independent risk factors for 3-year mortality. The Journal of Nutrition, Health and Aging©.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Chivite D.,Hospital Universitari Of Bellvitge | Rubio-Rivas M.,Hospital Universitari Of Bellvitge | And 2 more authors.
Age and Ageing | Year: 2011

Background: few studies have prospectively evaluated long-term predictors of mortality in nonagenarians. Objective: to determine predictors of death in a nonagenarian cohort after 5 years of follow-up. Design: a prospective community-based study. Setting: a community-based study. Subjects: one hundred and eighty-six nonagenarians both living in the community and institutionalised. Methods: functional status was determined by the Lawton-Brody and Barthel Indexes (BI) and cognition by the Spanish version of the mental state examination (MEC). The Charlson Index was used to measure comorbidity. Nutritional status was evaluated by the short version of the Mini-Nutritional Assessment questionnaire. Results: mortality after 5 years was 75.53%. Patients who did not survive were significantly older, with lower cognitive and functional performance, with diminished visual acuity, higher comorbidity, high risk of malnutrition, higher number of drugs taken and a higher percentage of patients with the diagnosis of dyslipidaemia, heart failure or previous stroke. Cox regression analysis, identified the Charlson Index (hazard ratio 1.23, 95% CI 1.09-1.37) and MEC (hazard ratio 0.98, 95% CI 0.97-0.99) as independent predictors of mortality after 5 years. Conclusions: better cognitive status and lesser comorbidity at baseline are the best predictors to identify which nonagenarians survived after a 5-year follow-up period. © The Author 2010. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Rodriguez Molinero A.,Geriatric Unit Fundacio Hospital Comarcal Sant Antoni Abat | Fraga A.,Hospital Universitari Of Bellvitge | And 2 more authors.
Journal of Nutrition, Health and Aging | Year: 2010

Objectives: To evaluate vital status after five years of follow-up in a cohort of nonagenarians with functional and/or cognitive impairment at baseline. Design: Prospective cohort study. Setting: A communitybased study. Participants: Nonagenarians enrolled in the NonaSantfeliu study. Measurements: Functional status was determined by the Lawton-Brody and Barthel indexes (BI), while cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC). Nonagenarians scoring up to 59 points on the BI were defined as individuals with significant functional impairment. Nonagenarians with cognitive decline were defined as those individuals with a score of 23 or less on the MEC. Subjects scoring <60 on the BI and <24 on the MEC were considered to show combined impairment (both functional and cognitive). Results: Sixty-three of 71 (88.8%) subjects with a BI <60 and 73 of 84 (86.9%) with a MEC score <24 had died after five years. Forty-eight of 53 nonagenarians (90%) with combined impairment died during the same follow-up period. A prior diagnosis of heart failure was the only variable associated with higher mortality in the three groups of subjects. Conclusion: Most of the nonagenarian subjects with functional and/or cognitive impairment at baseline had died at five-year follow-up © 2010 Serdi and Springer Verlag France.


Formiga F.,Hospital Universitari Of Bellvitge | Ferrer A.,Primary Health Care Center El Pla I | Camafort M.,Hospital Comarcal | Sobrino J.,Esperit Sant Hospital | Pujol R.,Hospital Universitari Of Bellvitge
Hipertension y Riesgo Vascular | Year: 2010

Objective: To study the influence of the circadian patterns of blood pressure and other factors related to geriatric evaluation in mortality of a nonagenarian cohort after a 3-year follow-up. Patients and methods: A total of 43 persons who formed a part of a Nona Santfeliu cohort were studied prospectively. A 24-hour ambulatory blood pressure monitoring (ABPM) study was performed. Sociodemographic, global geriatric evaluation and comorbidity data were collected. The nonagenarian subjects were followed-up for at least 36 months or until death. Results: The study was formed by 26 women (62%) and 16 men, with a mean of 93.7±2 years at the onset of the study. Twenty patients died during the three years of follow-up (47.6% mortality rate). There were no significant differences regarding mortality between the different 24-hour ABPM BP circadian patterns (p=0.16). The only statistically significant difference presented by the patients who died regarding those surviving at three years was that they the score had been worse on the cognitive mini-exam of Lobo. Conclusions: No statistically significant differences were found regarding mortality between the different circadian patterns of blood pressure of nonagenarian patients. The study shows that having a higher score on the cognitive evaluation is the best mortality predictor after three years of follow-up, regardless of the circadian pattern of ABPM of the BP. © 2009 SEHLELHA.


PubMed | Primary Health Care Center El Pla I
Type: Journal Article | Journal: Archives of gerontology and geriatrics | Year: 2012

Falls are a source of morbidity and mortality in the oldest old. The purpose of this study was to describe the prevalence of falls among community-dwelling 85-year-olds and to study the factors associated with falling. A cross-sectional study, including geriatric assessment, was conducted within the framework of the Octabaix Study. Functional status was measured with Barthel Index (BI) and Lawton Index (LI), cognitive impairment was assessed with the Mini-Mental State Examination (MMSE), the Spanish version of which is called MEC, Comorbidity by Charlson Index (CCI), and data were gathered on nutritional risk, social risk, falls, and drugs. The fall prevalence among the 328 octogenarians studied was 28.4%. A bivariate analysis revealed an association with being female (p=0.017) and poorer functional status according to BI (p=0.027). Logistic analysis showed an association with female gender (OR=1.96; 95%CI=1.15-3.33; p=0.014), BI (OR=0.98; 95%CI=0.97-0.99; p=0.007) and MEC (OR=1.05; 95%CI=1.01-1.09; p=0.027). The prevalence of falls among 85-year-olds is high and similar to that described in those aged 65 or over. The analyses show that being female, a degree of disability and a good score on cognitive status were independent risk factors for falls among these community-dwelling.

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