The objective of this study is to examine the prevalence and factors associated with frailty in Peruvian Navy Veteran's older adults and family members. A total of 311 non-institutionalized men and women aged 60 years and older, from the Geriatrics Service of the Peruvian Navy Medical Center (Centro Médico Naval “Cirujano Mayor Santiago Távara”) were assessed between May and October 2010. Frailty was defined as having two or more of the following components: 1) unintentional weight-loss, 2) weakness (lowest 20% in grip-strength), 3) self-reported exhaustion, and 4) slow walking speed (lowest 20% 8-meter walk-time in seconds). Additionally, information on socio-demographic factors, medical conditions, depressive symptoms, disability, and cognitive function were obtained. Of the 311 participants, 78 (25.1%) were not frail, 147 (47.3%) were pre-frail, and 86 (27.8%) were frail. Using logistic regression analysis, we found that older age, being married, falls in the last year and disability were factors significantly associated with being frail. We conclude that prevalence of pre-frail and frail status in Peruvian Navy Veterans and family members is high. Our data reports risk factors for frailty that have been reported in the past in other population groups. A larger sample and longitudinal follow-up are needed to design and implement comprehensive geriatric interventions that can benefit Peruvian Navy Veteran's older adults at risk of becoming frail.

To understand how the COVID-19 pandemic has affected caregivers, we assessed its perceived impact on caregiving through a new measure: the Caregiver COVID-19 Limitations Scale (CCLS-9), in Spanish and English. We also compared levels of caregiver self-efficacy and burden pre-COVID-19 and early in the pandemic. We administered surveys via internet to a convenience sample of caregivers in January 2020 (pre-pandemic, n = 221) and in April–June 2020 (English, n = 177 and Spanish samples, n = 144) to assess caregiver self-efficacy, depression, pain, and stress. We used the early pandemic surveys to explore the validity of the CCLS-9. The pre-COVID-19 survey and the April English surveys were compared to determine how the COVID-19 pandemic affected caregivers. The CCLS-9 had strong construct and divergent validity in both languages. Compared to pre-COVID-19, caregiver stress ( p = .002) and pain ( p = .009) were significantly greater early in COVID-19, providing evidence of its validity. COVID-19 added to caregiver stress and pain.

With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.

No abstract

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.ObjectiveThe 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$ 23 over three months, demented patients had costs of US$ 1500 or over (and more than US$ 1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US$ 570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US$ 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 patient's family.

No abstract

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

No abstract