Rosalinda Sánchez-Arenas

Frailty among community-dwelling elderly Mexican people: Prevalence and association with sociodemographic characteristics, health state and the use of health services

To estimate the prevalence of frailty phenotypes and their association with the sociodemographic characteristics, health state and the use of health services in the last 6 months among community‐dwelling elderly in Mexico City.

Genetic admixture and diversity estimations in the Mexican Mestizo population from Mexico City using 15 STR polymorphic markers

The 15 AmpFlSTR Identifiler loci D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818 and FGA were analyzed in a sample of 378 unrelated individuals from Mexico City, Mexico. Significant deviations from HW equilibrium in 14/15 STR loci alleles were not detected. The D18S51 locus had the highest power of discrimination (0.970). Genetic admixture estimations revealed a 69% of Amerindian, 26% of European and 5% of African contribution. Comparative analyses between Mexicans and other neighboring populations reveal significant differences in genetic diversity. Our results are important for future comparative genetic studies in different Latin American ethnic groups, particularly Mexican Mestizos and Amerindians. They should also be helpful in genetics, population evolution, forensic and paternity testing.

Prevalence of Mild Cognitive Impairment and Its Subtypes in the Mexican Population

Background/Aim: To estimate the prevalence of mild cognitive impairment (MCI) and its subtypes, taking into account education and health status. Methods: This is the first report of our Study on Aging and Dementia in Mexico. This study included 2,944 elderly individuals 60 years old or more with in-home assessment for cognitive impairment. The prevalence of MCI was based on Petersen criteria. MCI was classified as amnestic of single domain (a-MCI-s) or multiple domain (a-MCI-md) or nonamnestic of single domain (na-MCI-s) or multiple domain (na-MCI-md). In addition to a battery of neuropsychological measures, a self-report depression measure and a medical history including history of stroke, heart disease and other health conditions were recorded. Results: The global estimated prevalence of MCI in the Mexican population was 6.45%. Of these subjects, 2.41% met criteria for a-MCI-s, 2.56% for a-MCI-md, 1.18% for na-MCI-s and 0.30% for na-MCl-md. Women showed a higher prevalence of MCI than men (63.7 vs. 36.3%, respectively). The analysis showed that heart disease [odds ratio (OR) 1.5], stroke (OR 1.2) and depression (OR 2.1) were associated with an increased risk of MCI. Conclusions: The prevalence of MCI in Mexico is similar to that in other countries. The results suggest that stroke, heart disease and depression may have an important role in the etiology of MCI.

Value of EQ-5D in Mexican city older population with and without dementia (SADEM study).

The EuroQoL‐5D (EQ‐5D) is a brief, multi‐attribute, preference‐based health status measurement. The objective of this study was to assess the validity and reliability of EQ‐5D in older adults with and without dementia in Mexico City.

Frailty in community-dwelling older adults: association with adverse outcomes

Background The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. Methods A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD). Results Frailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR) =2.3 (95% confidence interval [CI] 1.7–3.2) and adjusted OR =1.7 (95% CI 1.2–2.4); falls OR =1.6 (95% CI 1.2–2.1) and adjusted OR =1.4 (95% CI 1.0–1.9); admission to emergency services OR =1.9 (95% CI 1.1–3.1) and adjusted OR =1.9 (95% CI 1.1–3.4); low quality of life OR =3.4 (95% CI 2.6–4.6) and adjusted OR =2.1 (95% CI 1.5–2.9). Conclusion Approximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life.

Reliability of EQ‐5D for use in population with and without dementia (SADEM study)

The assessment of health-related quality of life (HRQoL) of patients with dementia is considered to be important in public health research and the evaluation of medical and psychosocial treatment. The EuroQol-five dimensions (EQ-5D) is a short generic patient-rated questionnaire for subjectively describing and evaluating HRQoL (Gonzalez-Salvador et al., 2000). The generic EQ-5D is a brief and easy to administer instrument that provides scores for different health dimensions as well as an index value, which can be used to assess health status (López-Bastida et al., 2008). In order to investigate the reliability, and validity of the EQ-5D in patients with and without dementia, a validation study was recently undertaken through the alpha of Cronbach with latent variable or dimension in order to calculate reliability and, therefore, utility of this instrument in a very specific population. Considering that there are some problems with determining the reliability of the EQ-5D-3 L, we would like to take some methodological aspects to clarify why we used internal consistency for the measurement (Sanchez-Arenas et al., 2014).

Drug-drug interactions at hospital admission in geriatric patients in a single facility: a retrospective study.

BACKGROUND Individuals older than 60 years of age have multiple simultaneous diseases, for which the average number of medications is greater than five, leading up to 3% possibility of having an adverse reaction event. OBJECTIVE To detect potential drug-drug interactions (PDDIs) and report the average hospital stay for severity potential PPIs, in adults 60 years of age and older in an Internal Medicine Service. METHODS This was a retrospective analysis with a review of the clinical records of patients 60 years of age and older. The length of stay, number and type of prescribed daily medications, PDDIs, and number of admission diagnoses for each patient, were reviewed. RESULTS This study included 342 patients with an average and standard deviation of 6 ± 3.0 medications per day. The PDDI levels were 27 (7.9%) severe, 94 (27.5%) moderate, and 61 (17.8%) had both types of interactions. Severe interactions, presented a hospital stay of 10 days, and moderate interaction a 13-day stay. CONCLUSION The most common interactions and their average length of stay may be utilized for quality evaluation of the medication process of such a major patient population as that of the older adult in the hospital setting.

Oxidative stress in an aged population with diabetes mellitus and/or hypertension

Mexico City has the highest aging rate in the country, as well as a high prevalence of diabetes mellitus (DM) and hypertension (HAS). All three on their own, are known to increase oxidative stress (OE). With this study, we have described changes in OE in 18 patients without DM or HAS, 12 with DM, 23 with HAS, and 18 with DM and HAS. The EO was measured by the quantification of reactive oxygen species (ROS), and by determination of lipid peroxidation. HAS patients showed increased ROS levels as did men with HAS compared with the respective DM and HAS groups. Also, women of the control group showed higher levels of ROS compared with men. HAS in an aged population turned out to be the most influential factor for oxidative stress increase while DM had no effect whatsoever.Background Mexico City has the highest aging rate in the country, as well as a high prevalence of diabetes mellitus (DM) and arterial hypertension (HT). All three on their own, are known to increase oxidative stress (OE). Methods Final groups included 18 patients without DM or HT (control group), 12 with DM, 23 with HT, and 18 with DM and HT. The EO was measured by the quantification of reactive oxygen species (ROS), and by determination of lipid peroxidation. Results HAS patients showed increased ROS levels as did men with HAS compared with the respective DM and HT groups. Also, women of the control group showed higher levels of ROS compared with men. HT in an aged population turned out to be the most influential factor for oxidative stress increase while DM had no effect whatsoever.

Association of oxidative stress, telomere length, and frailty in an elder population

Background A global aging population requires focusing on the risk factors for unhealthy aging, preventive medicine, and chronic disease management. The identification of adverse health outcomes in older adults has been addressed by the characterization of frailty as a biological syndrome. On the other hand, oxidative stress and telomere length have been suggested as biomarkers of aging. Objective To study the association of oxidative stress, telomere length, and frailty in an old age population. Methods This was a cross-sectional study based on 2015 data from 202 members from a cohort of older adults (n=202; gender F/M ratio: 133/69; mean age: 69.89 ± 7.39 years). Reactive oxygen species (ROS) were measured by dichlorofluorescin diacetate, and lipid peroxidation by malondialdehyde. Telomere length was determined using qPCR with SYBR Green Master Mix. Results Statistical analysis showed an association between telomere length and frailty but no association between oxidative stress on telomere length or frailty. Conclusions Telomere length could eventually be used as a marker to discriminate between healthy and unhealthy aging as expressed by frailty phenotype. However, oxidative stress seems as just a biological process of aging.

Telomere shortening and frailty in Mexican older adults: Telomere and frailty in Mexican adults

Telomere shortening has been associated with several age‐related diseases, in addition to being considered a hallmark of aging. Frailty is a clinical syndrome characterized by an accentuated physiological and functional decline that might be a predictor of an adverse condition in older age. The present study evaluated the relationship between frailty and telomere shortening in older adults from Mexico City, Mexico.