Browsing by Subject "Frailty"

Now showing 1 - 4 of 4
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    Atrial fibrillation management in older heart failure patients: a complex clinical problem
    (Wichtig Publishing, 2016-09-22) Pulignano, Giovanni; Del Sindaco, Donatella; Tinti, Maria Denitza; Tolone, Stefano; Minardi, Giovanni; Lax Pérez, Antonio Manuel; Uguccioni, Massimo; Medicina
    Background: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients. Methods: PubMed was searched for studies on AF and older patients using the terms atrial fibrillation, elderly, heart failure, cognitive impairment, frailty, stroke, and anticoagulants.Results: The clinical picture of HF patients with AF is complex and heterogeneous with a higher prevalence of frailty, cognitive impairment, and disability. Because of the association of mental and physical impairment to non-administration of oral anticoagulants (OACs), screening for these simple variables in clinical practice may allow better strategies for intervention in this high-risk population. Since novel direct OACs (NOACs) have a more favorable risk-benefit profile, they may be preferable to vitamin K antagonists (VKAs) in many frail elderly patients, especially those at higher risk of falls. Moreover, NOACs are simple to administer and monitor and may be associated with better adherence and safety in patients with cognitive deficits and mobility impairments. Conclusions: Large multicenter longitudinal studies are needed to examine the effects of VKAs and NOACs on long-term cognitive function and frailty; future studies should include geriatric conditions.
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    Caída y factores demográficos y clínicos en adultos mayores: estudio de seguimiento
    (Universidad de Murcia. Servicio de publicaciones, 2021) Silva Fhon, Jack Roberto; Partezani Rodrigues, Rosalina Aparecida
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    Intervención multicomponente sobre estilos de vida en ancianos frágiles del medio rural. Proyecto piloto
    Huarte Ruiz, Iratxe; Recio Rodríguez, José Ignacio; Ciencias Sociosanitarias (Lorca); Universidad de Burgos. Facultad de ciencias de la salud. Grado en enfermería
    Introducción y justificación: Las intervenciones de ejercicio físico multicomponente han resultado ser las más efectivas a la hora de retrasar la discapacidad y otros factores adversos. Sin embargo, no existen estudios que determinen las características más adecuadas en su diseño y las intervenciones enfocadas a los ancianos rurales son muy escasas. Objetivo: Evaluar el efecto de una intervención multicomponente sobre estilos de vida en ancianos frágiles del medio rural teniendo como principal marcador de control, la mejora de la calidad de vida relacionada con la salud. Material y métodos: Se realizará un ensayo clínico aleatorizado de dos grupos paralelos en una zona rural del sureste de la provincia de Burgos. Se reclutarán 174 personas por muestreo consecutivo con una edad superior o igual a 65 años, residentes en Quintanar de la Sierra y que cumplan al menos un criterio de fragilidad. Tras la evaluación basal, los participantes serán aleatorizados en dos grupos: Grupo control: Recibirá un consejo breve sobre estilos de vida – Grupo intervención: Recibirá, además, una intervención multicomponente: individual, con pautas generales de alimentación saludable y ejercicio físico, grupal, con dos talleres prácticos de cocina saludable y ejercicio físico y comunitario, derivándolos a la participación de diversas actividades en asociaciones de la localidad. La variable principal de evaluación será la mejora de calidad de vida relacionada con la salud. Las variables secundarias serán la mejora de los valores que indican fragilidad y la modificación de los estilos de vida. Todas las variables serán evaluadas en la visita basal, al mes y a los 6 meses. Relevancia: Los resultados de este estudio podrían trasladarse rápidamente a la clínica incorporándolos en la “Estrategia de prevención de la dependencia para las personas mayores y de promoción del envejecimiento activo en Castilla y León 2017-2021” y en los programas municipales de Envejecimiento Activo
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    Isometric knee extension test: A practical, repeatable, and suitable tool for lower-limb screening among institutionalized older adults
    (Elsevier, 2021-09-26) Conesa Ros, Elena; Courel Ibáñez, Javier; Hernández Belmonte, Alejandro; Martínez Cava, Alejandro; García Conesa, Silverio; Buendía Romero, Ángel; Franco López, Francisco; Actividad Física y Deporte
    We aimed to analyze the isometric knee extension test (IKE) test in terms of i) intra- and inter-session repeatability, and ii) relationship with functional and body composition factors of sarcopenia among institutionalized older adults. Thirteen institutionalized older adults (age = 87 ± 10 years, body mass [BM] = 73.1 ± 10.9 kg, body mass index [BMI] = 28.5 ± 3.8 kg·m2) were recruited from a nursing home. Variability of maximal isometric force registered in three IKE trials performed on the same day was used to examine intra-session repeatability, whereas inter-session repeatability was analyzed by comparing maximal isometric force from two different days. Furthermore, functional (Handgrip, 6-m Gait Speed, Time Up and Go [TUG], and Sit-to-stand tests) and body composition (appendicular lean mass adjusted by BMI, ALM/BMI) evaluations were conducted. Statistics included the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM), expressed in both absolute (N·kg-1) and relative terms (coefficient of variation, CV = 100 × SEM / mean). High to very high intra-session repeatability was found for both the dominant and non-dominant legs (CV ≤ 6.0%, ICC ≥ 0.989). Similarly, both legs showed high inter-session repeatability (SEM ≤ 0.26 N·kg-1, ICC ≥ 0.959). On the other hand, significant relationships were found between Dominant and Non-dominant IKE tests and 6-m Gait Speed (r = 0.77; r = 0.58), ALM/BMI (r = 0.62; r = 0.58), and Non-dominant Handgrip/BM (r = 0.60; r = 0.68). In addition, a significant association was found between Dominant IKE/BM and TUG (r = -0.74), as well as between Non-dominant IKE/BM and Dominant Handgrip/BM (r = 0.67). These findings suggest that the IKE test is a repeatable and suitable strategy for lower-limb screening in institutionalized older adults.