Servicio de Geriatria

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Servicio de Geriatria

Spain
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Rodriguez-Molinero A.,Servicio de Geriatria | Rodriguez-Molinero A.,National University of Ireland | Narvaiza L.,Servicio de Geriatria | Galvez-Barron C.,Servicio de Geriatria | And 2 more authors.
Revista Espanola de Geriatria y Gerontologia | Year: 2015

Introduction: Falls in the elderly constitute a public health concern. The objective of the present study wasto collect updated data on the frequency of falls in the Spanish elderly population, as well as to analysetheir consequences and associated risk factors. Material and methods: This prospective study was conducted on a probabilistic sample of 772 Spanish, community dwelling, older adults. During the baseline visit, data were collected on functional capacity, history of falls, disease background, number of medications used, balance impairment, use of walkingaids, cognitive capacity and depression symptoms. Participants were followed up for one year by meansof quarterly phone calls, where they were asked about the number of falls occurred in that period, as wellas their consequences and associated use of healthcare resources. Results: During the one-year follow up period, 28.4% (95%CI 24.9-32.1) of participants suffered one ormore falls, while 9.9% (95%CI 7.4-11.4) suffered multiple falls. One-third of the falls were due to accidentalextrinsic causes. Among participants who had suffered falls, 9.3% suffered a fracture (3.1% hip fracture),and 55.4% required healthcare services (29% were managed in the hospital emergency room, and 7.3%were admitted to hospital). Risk factors identified through multivariate analysis were: advanced age(> 79 years), not having a companion, using more than 2 drugs, dependency in BADLs, impaired strengthor balance, and use of walking aids. Conclusions: Falls continue to be a major public health concern in Spain. Given that some of the associatedrisk factors may be modified, introducing programs aimed at tackling this problem should be regarded asa priority. © 2014 SEGG.


Gomez-Candela C.,Hospital Universitario La Paz | Vazquez N.G.,Servicio de Farmacia | Alarcon-Alarcon T.,Servicio de Geriatria | Gonzalo L.S.,Servicio de Anestesia y Reanimacion. | Robledo J.P.P.,Servicio de Anestesia y Reanimacion.
Revista Espanola de Nutricion Comunitaria | Year: 2014

Introduction: There is a high prevalence of hydration disorders in the hospitalized population. Objectives: In addition to promoting the prevention of dehydration and its early diagnosis, we intend to standardize fluid therapy practices with the aim of reducing complications and improving the prognosis of our patients. Material and methods: A multidisciplinary workgroup consisting of members from the Nutrition Quality Committee was formed, all interested in the subject, and whose area of expertise was relevant to the group. The issues were distributed amongst the team members based on their knowledge area, and a literature review was conducted. They held monthly meetings throughout 2013, and they developed this protocol upon the clinical experience accumulated. Results: A Hydration Protocol was developed that starts with the identification of patients and clinical situations at risk of dehydration and subsequently identifies the clinical signs and symptoms of risk. Other laboratory tests are subsequently performed, such as hematocrit, serum and urinary electrolytes, renal function and acid-base balance tests. All of these parameters allow us to make the diagnosis of the hydration state, classifying patients as hyper-hydrated, well-hydrated or dehydrated and defining the severity of the process. The protocol establishes the most appropriate way to calculate, individually, the daily water, sodium, potassium and chloride requirements; it tries to ensure a supply of at least 125 grams per day of glucose. We reviewed different oral and intravenous rehydration patterns, depending on the plasma sodium level and its follow-up. Finally, we proposed a new guideline of standard fluid therapy. Conclusions: We consider that this protocol is very important for our hospital clinical practice, and once implemented, the results will be evaluated and new modifications or other corrective measures will be established.


Besga A.,Servicio de Geriatria | Ortiz L.,Complutense University of Madrid | Fernandez A.,Complutense University of Madrid | Maestu F.,Complutense University of Madrid | And 4 more authors.
Alzheimer Disease and Associated Disorders | Year: 2010

The aim of this study was to analyze the combined contribution of magnetic resonance imaging and magnetoencephalography (MEG) to the diagnosis of mild cognitive impairment (MCI) and AD. To whole-head MEG recordings were obtained from three diagnosis groups: Alzheimer disease (AD), MCI, and control. Magnetic resonance imaging volumetric data of global brain, temporal lobe, and hippocampal volumes, were also obtained. Results indicated that a reduction of volume in the hippocampal structure allowed the discrimination between AD and MCI patients as compared with controls. The percentage of correct classification was 91.3% when AD versus controls was compared, and 83.3% when we compared MCI versus control. MEG data showed that AD patients exhibit higher θ and δ activity than MCI and controls. Such higher activity was significant in parietal, temporal, and occipital areas. Left parietal theta classified controls versus MCIs with 78.3% rate of correct classification. Right occipital theta and the left parietal delta allowed the discrimination of controls versus ADs, with 81.8% rate of correct classification. Left parietal theta discriminated between ADs and MCIs with 56.6% rate of correct classification. In addition, the combination of both techniques significantly improved the rate of correct classification, thus indicating that a multidisciplinary perspective of techniques may improve the diagnostic capabilities. © 2010 by Lippincott Williams & Wilkins.


Roig T.,Servicio de Geriatria | Marquez M.T.,Hospital Of La Esperanza | Hernandez E.,Hospital Of La Esperanza | Pineda I.,Hospital Of La Esperanza | And 3 more authors.
Revista Espanola de Geriatria y Gerontologia | Year: 2013

Introduction and objectives: Heart failure (HF) is very prevalent in older adults, and is associated with a high mortality. The prediction of the outcome of HF and the identification of patients in advanced stages is difficult. The present work aims at identifying variables of the geriatric assessment and other clinical variables associated with an increased risk of death at one year in older adults with HF. Material and methods: Prospective study of 101. patients (mean age, 85.9. ±. 6.3. years, 81% women) admitted during 2006 to an Acute Geriatric Unit, with principal diagnosis of HF. We recorded: demographic data, predisposing heart disease, main trigger of exacerbation, comorbidity, number of prescriptions at discharge and specific treatment of HF, average length-of-stay, readmissions, and mortality at one year after discharge. Geriatric assessment included: disability in basic (Barthel index) and instrumental (Lawton index) activities of daily living, cognitive function (Pfeiffer test), comorbidity (Charlson index), and geriatric syndromes. Results: In a multivariable logistic regression model, previous disability (lower Barthel index) (OR [95%CI] = 1.03 [1.01-1.06]; P = .040) and higher number of re-admissions (OR [95%CI] = 3.53 [1.19-10.44]; P = .023) were associated with 1-year mortality. Female sex had a protective effect (OR [95%CI] = 0.15 [0.04-0.59]; P = .007). Conclusions: Disability in the basic activities of daily living and re-admissions were associated with increased 1-year mortality in older adults, whereas female sex was protective. If confirmed in further studies, these data could reinforce the need for a systematic comprehensive geriatric assessment in older adults with HF. © 2013 SEGG.


Zenon T.G.,Servicio de Geriatria | Villalobos Silva J.A.,Hospital Regional Of Alta Especialidad Bicentenario 2010
Medicina Interna de Mexico | Year: 2012

Undernutrition is associated with multiple adverse health consequences, since immune dysfunction, until increased mortality. The reasons for this entity in older people are multiple. Although there is not a totally accepted method for the diagnostic, the Malnutrition Universal Screening Tool (MNA) and the Subjective Global Assessment (SGA) are the most commonly used tools. Treatment includes a dietetic assessment and the correction of the underlying causes, by example, dental problems and depression. The evidence supporting any orexigenic pharmacologic agent for the treatment of weight loss in elderly is limited.


PubMed | Servicio de Geriatria
Type: Journal Article | Journal: Revista espanola de geriatria y gerontologia | Year: 2011

Since forming the Osteoporosis, Falls and Fractures Group of the Spanish Society (GOCF) of Geriatrics and Gerontology (SEGG) a review was performed of the epidemiology of falls, along with a description of measures that have shown a degree of effectiveness in prevention. We also present the proposal of a common basic model of action in fall prevention units, mainly addressed to the community. Finally, a consensus model falls register is presented, common to community level and institutional areas, with the objective of being useful and easy to fill in at any care level.


PubMed | Servicio de Geriatria
Type: Journal Article | Journal: Revista espanola de geriatria y gerontologia | Year: 2013

Heart failure (HF) is very prevalent in older adults, and is associated with a high mortality. The prediction of the outcome of HF and the identification of patients in advanced stages is difficult. The present work aims at identifying variables of the geriatric assessment and other clinical variables associated with an increased risk of death at one year in older adults with HF.Prospective study of 101 patients (mean age, 85.9 6.3 years, 81% women) admitted during 2006 to an Acute Geriatric Unit, with principal diagnosis of HF. We recorded: demographic data, predisposing heart disease, main trigger of exacerbation, comorbidity, number of prescriptions at discharge and specific treatment of HF, average length-of-stay, readmissions, and mortality at one year after discharge. Geriatric assessment included: disability in basic (Barthel index) and instrumental (Lawton index) activities of daily living, cognitive function (Pfeiffer test), comorbidity (Charlson index), and geriatric syndromes.In a multivariable logistic regression model, previous disability (lower Barthel index) (OR [95%CI]=1.03 [1.01-1.06]; P=.040) and higher number of re-admissions (OR [95%CI]=3.53 [1.19-10.44]; P=.023) were associated with 1-year mortality. Female sex had a protective effect (OR [95%CI]=0.15 [0.04-0.59]; P=.007).Disability in the basic activities of daily living and re-admissions were associated with increased 1-year mortality in older adults, whereas female sex was protective. If confirmed in further studies, these data could reinforce the need for a systematic comprehensive geriatric assessment in older adults with HF.

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