José F. Parodi

Rendimiento físico de adultos mayores residentes en zonas rurales a nivel del mar y a gran altitud en Perú

INTRODUCTION Living at high altitudes requires the inhabitants to adapt biologically and socially to the environment. The objective of this study was to determine the difference in physical performance (PP) in rural populations at sea level and at high altitude. MATERIAL AND METHODS A cross-sectional study was conducted in rural communities in Ancash, Peru, located at 3.345 meters above sea level (m.a.s.l.) and also in communities located in coastal areas at 6m.a.s.l. PP was measured by the Short Physical Performance Battery (SPPB) and other associated factors. Adjusted prevalence ratios (aPR) were calculated. RESULTS A total of 130 older adults were assessed in the high altitude communities and 129 on the coast. The median age was 71.4 years, and 55.6% were female. Low physical performance (SPPB ≤ 6) was 10.0% at high altitude and 19.4% on the coast (p<0.05). Factors associated with low physical performance were residing at the coast (aPR: 2.10, 95% CI 1.02 to 4.33), self-reported poor health (aPR: 2.48, 95% CI 1.21 -5.08), hypertension (aPR: 1.73, 95% CI 1.01 to 2.98), and age (aPR: 1.04, 95% CI 1.01 to 1.07), while being a farmer (aPR: 0.49, 95% CI 0.25 to 0.97), and being independent (aPR: 0.37, 95% CI 0,20-, 072) were found to be protective factors. It was also found that the inhabitants of the coast have a mean of 0.86 points lower total SPPB than the high altitude ones (p=0.004). CONCLUSIONS There is an association between altitude of residence and PP in older adults. The prevalence of a low PP in older adults in rural areas at sea level is twice as high compared to those living in high altitude rural communities.

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries. Objective The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru. Methods. We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs). Results. In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US

Informal caregiver burden in middle-income countries: results from Memory Centers in Lima - Peru

23 over three months, demented patients had costs of US

Factors associated with poor balance ability in older adults of nine high-altitude communities

1500 or over (and more than US

Functional assessment as a predictor of cognitive impairment: a retrospective cohort study

1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US

Prevalence and Factors Associated with Frailty Among Peruvian Older Adults

570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US

Calf circumference and risk of falls among Peruvian older adults

222.22). Conclusion. Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patients family.

Frailty and vulnerability as predictors of radiotoxicity in older adults: A longitudinal study in Peru

Objective The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). Methods Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. Results A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimers disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). Conclusion This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI.

Fragilidad y vulnerabilidad como predictores de radiotoxicidad en adultos mayores: un estudio longitudinal en Perú

INTRODUCTION Poor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities. MATERIAL AND METHODS Analytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013-2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented. RESULTS A total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05-1.73), exhaustion (PR = 2.22; 95%CI: 1.49-3.31), gait speed (PR = 0.67; 95%CI: 0.50-0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19-3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10-2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07-2.42) compared to none. CONCLUSIONS Approximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals.

Evaluación de la prueba de la moneda peruana en el tamizaje de trastorno cognitivo en adultos mayores

INTRODUCTION It is estimated that major neurocognitive disorders will affect 115.4 million people by 2050, representing a significant financial burden for society. Likewise, functional dependence for basic or instrumental activities of daily life is usually a consequence of the greater prevalence of disabling pathologies, and of the progressive decrease of the physiological reserve due to aging. OBJECTIVES To determine the ratio between the functional test and prediction of deterioration of cognitive function in geriatric patients. To determine which factors are associated with decreased cognitive functions in elderly patients. METHODS This is a retrospective cohort study. We included participants who attended the Geriatrics Outpatient Services of the Naval Medical Center of Peru from 2010 to 2014. Two groups were formed, the first comprised those who presented physiological loss of cognitive functions, defined as the decrease less than 4.1 points in the score of the Mini Mental State Examination during follow-up and a second group who had a pathological loss of cognitive functions, defined as a decrease of 4.2 points in average or more in the Mini Mental State Examination score during follow-up. Patients were followed for four years, performing functional evaluations, as well as collecting data on comorbidities and sociodemographic factors. RESULTS We included 368 patients, whose mean age was 75.8 years and 50.91% male. Female gender (53.72%), poor education (62.81%), and comorbidities were statistically more frequent in the pathological cognitive decline group. Functional assessment variables had a worse disease progress through follow-up in the group with pathological disease progress of the Mini Mental State Examination score, including Timed Up and Go Test. CONCLUSIONS Score values of Timed Up and Go Test manage to predict the risk of a pathological decrease in Mini Mental State Examination regardless of sociodemographic factors, comorbidities, and functional assessment.