Fragilidad en ancianos que viven en la comunidad con y sin enfermedad cerebrovascular previa

Preto, Leonel São Romão; Conceição, Maria do Carmo Dias; Amaral, Simone Isabel Soeiro; Figueiredo, Telma Martins; Sánchez, Antonio Ramos; Fernandes, Ana Sofia

doi:10.1016/j.sedene.2017.07.001

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…CVA related functional limitations are similar to those of frail elderly people. Namely, post-stroke fatigue is associated with reduced quality of life and greater risk of death [103,104].…”

Section: Discussionmentioning

confidence: 99%

Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital

Cano‐Escalera

Graña

Irazusta

et al. 2023

JCM

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Background: Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality. Materials: Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR. Methods: Kaplan–Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty (p < 0–05) were extracted by independent sample t-test. Further selection was based on variable significance found in multivariate logistic regression discrimination between frail and pre-frail subjects. Cox regression over univariate t-test-selected variables was calculated to identify variables associated with higher proportional hazard risks (HR) at two years. Results: Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test, p < 0.0001). Variables with significant (p < 0.05) association with mortality identified in both cohorts (HR 95% (CI in the frail cohort) are male sex (0.44 (0.29–0.66)), age (1.05 (1.01–1.09)), weight (0.98 (0.96–1.00)), and use of proton-pump inhibitors (PPIs) (0.60 (0.41–0.87)). Specific high-risk factors in the frail cohort are readmission at 30 days (0.50 (0.33–0.74)), SPPB sit and stand (0.62 (0.45–0.85)), heart failure (0.67 (0.46–0.98)), use of antiplatelets (1.80 (1.19–2.71)), and quetiapine (0.31 (0.12–0.81)). Specific high-risk factors in the pre-frail cohort are Barthel’s score (120 (7.7–1700)), Pfeiffer test (8.4; (2.3–31)), Mini Nutritional Assessment (MNA) (1200 (18–88,000)), constipation (0.025 (0.0027–0.24)), falls (18,000 (150–2,200,000)), deep venous thrombosis (8400 (19–3,700,000)), cerebrovascular disease (0.01 (0.00064–0.16)), diabetes (360 (3.4–39,000)), thyroid disease (0.00099 (0.000012–0.085)), and the use of PPIs (0.062 (0.0072–0.54)), Zolpidem (0.000014 (0.0000000021–0.092)), antidiabetics (0.00015 (0.00000042–0.051)), diuretics (0.0003 (0.000004–0.022)), and opiates (0.000069 (0.00000035–0.013)). Conclusions: Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.

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Section: Discussionmentioning

confidence: 99%

Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital

Cano‐Escalera

Graña

Irazusta

et al. 2023

JCM

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“…Given this fact, it is estimated that by 2050, when almost half of the Mexican population will be over 60 years old, 50 % of hospital admissions will be related to cardiovascular problems, and the survivors will have severe physical and cognitive lesions (7) that generate disability-adjusted life years and years lived with disability, which interact unfavorably with OAs' intrinsic capacity and result in their total dependence (8).…”

Section: Introductionmentioning

confidence: 99%

Transition to the Role of Family Caregiver of Older Adults After a Stroke: A Specific Theory

Saucedo-Pahua,

López-González,

Gómez-García

et al. 2023

Aquichan

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Introduction: Nursing professionals develop situation-specific theories to describe, explain, and provide comprehensive care during a family member’s transition to the caregiver role. Objective: To develop a situation-specific theory about the transition to the role of family caregiver of older adults after a stroke. Methodology: The integrating approach by Meleis and Im was applied, which consists of five stages: 1) Description of the context and target population, 2) Verification of assumptions regarding the philosophical stance, 3) Exploration of multiple sources, 4) Theorization of concepts, and 5) Proposal of empirical indicators for validation and verification. Results: The prescriptive theory was developed in the light of Afaf Meleis’ Theory of Transitions and was supported by an exhaustive literature review, with four underlying concepts: Situational transition to the family caregiver role, Care-related knowledge and skills, Self-confidence and coping in adopting the caregiver role, and Nursing therapeutic education. The following assumption emerges from these concepts: a healthy transition to the family caregiver role is directly dependent on the care-related knowledge and skills provided by Nursing therapeutic education to develop self-confidence and coping in adopting the caregiver role. Conclusions: The proposal provides a conceptual framework that identifies the transition challenges and needs faced by family caregivers to adopt the role of caregivers of older adults after a stroke.

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“…Las lesiones físicas y cognitivas por ACV según su etiología generan Años de Vida Ajustados por Discapacidad (AVAD), Años de Vida Perdidos (AVP) debido a muerte prematura y los Años Vividos con Discapacidad (AVD), las cuales interactúan desfavorablemente en la capacidad intrínseca que deriva en dependencia total en el AM 5 .…”

Section: Introductionunclassified

Aplicaciones móviles para el autoaprendizaje en el cuidador del adulto mayor con accidente cerebrovascular: Revisión integradora

Saucedo,

Jiménez González,

Duran Badillo

et al. 2023

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Objetivo: Analizar la evidencia disponible en la literatura sobre intervenciones con aplicaciones móviles para favorecer el autoaprendizaje de atención y asistencia en el cuidador primario del adulto mayor, con secuelas físicas de accidente cerebrovascular. Material y Métodos: Revisión integradora de la literatura publicada entre Enero de 2018 y Junio 2022 en las bases de datos CINAHL, EMBASE, LILACS, PubMed, Scopus y EBSCOhost. Los datos obtenidos se analizaron en cuatro etapas: identificación del tema, muestreo, selección y categorización de estudios y análisis, evaluación e interpretación de resultados bajo el método CASPe. Resultados: 2 fueron cualitativos y 1 cuantitativo; las intervenciones digitales fueron: mHealth, Movies4Stroke y MoCaB utilizadas para el autoaprendizaje y asistencia en el cuidador primario en las dimensiones control de la presión arterial, glucosa, colesterol y adherencia farmacológica. Las intervenciones educativas digitales aumentan el autoaprendizaje y facilita la atención en el cuidador del adulto mayor con secuelas físicas por accidente cerebrovascular. Conclusiones: Las intervenciones educativas digitales para el autoaprendizaje y asistencia en el cuidador primario desde la evidencia científica son mínimas. Es necesario diseñar intervenciones digitales accesibles, dinámicas y de fácil interacción para el autoaprendizaje en la generación de habilidades de cuidados en el encargado primario del adulto mayor con secuelas físicas post accidente cerebrovascular. Palabras Clave: Aplicaciones móviles; Intervención basada en la Internet; Cuidadores; Accidente Cerebrovascular.

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Fragilidad en ancianos que viven en la comunidad con y sin enfermedad cerebrovascular previa

Cited by 5 publications

References 25 publications

Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital

Mortality Risks after Two Years in Frail and Pre-Frail Older Adults Admitted to Hospital

Transition to the Role of Family Caregiver of Older Adults After a Stroke: A Specific Theory

Aplicaciones móviles para el autoaprendizaje en el cuidador del adulto mayor con accidente cerebrovascular: Revisión integradora

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