Egoitzetako adineko pertsonen erorketetan eta hauskortasunean eragina duten parametroen eta adierazleen azterketa

202 p.Adineko pertsonen erorikoak hauskortasunarekin estuki erlazionaturik daude, eroriko gehiago gertatzen direla ikusi baita hauskortasun egoera batean. Horregatik, adineko pertsonetan hauskortasun egoera baten aurreikuspena lantzeak erorikoak gutxiagotu ditzake. Ideia honetatik abiatuz, tesi honetan, alde batetik, egoitzetan bizi diren adinekoen erorketen zein hauskortasunaren azterketa egin da. Bestetik, hauskortasunaren indikatzaile egokiak zein erorketak aurreikusteko erraza, sentikorra eta espezifikoa den probak zeintzuk izan daitezkeen bilatu nahi izan dira. Honetarako, Gipuzkoako 16 egoitza ezberdinetako 199 adineko pertsonen egoera funtzionala, egoera fisikoa, egoera kognitiboa eta egoera psikoafektiboa kontuan hartu dira.Gizonezko eta emakumezko egoiliarren profil desberdina ikusirik, bata eta besteari eskaini beharreko arreta egokitu behar dela ikusi dugu. Hauskortasunaren hiru galdetegiak kontuan hartuta lagin osoan faktore guztiek izan zuten eragina. Aldiz, sexuka aztertzean, hauskortasunean eragina zuten faktoreak ezberdinak ziren erabilitako galdetegien arabera; Fried fenotipoan eta Rockwood eskala klinikoan dimentsio fisikoak indar gehien zuen bitartean, Tilburg indizean dimentsio psikoafektiboak zuen indar gehien. Bestetik, hauskortasunaren indikatzaile sentikor eta espezifikoen artean, egoera fisikoko probak, Barthel galdetegia, eta emakumezkoetan batez ere, egoera psikoafektiboko parametroak izan ziren.Erorketei dagokionez, hauetan eragina izan zuten parametroen artean adina, egoera funtzionala, egoera fisikoa, hauskortasuna, ikasketa maila eta egoera psikoafektiboa aurkitzen ziren. Erorketak aurreikusteko parametro espezifiko eta sentikor bakarra lagin osoan, Barthel galdetegia izan zen. Sexukako azterketan, ordea, gizonezko egoiliarretan Barthel galdetegiaz gain, SPPB proba, TUG proba eta Rockwood eskala klinikoa izan ziren. Emakumezko egoiliarretan, adina, GMI-a, Barthel galdetegia, Tilburg indizea eta Goldberg-en depresioaren galdetegia izan ziren proba sentikor eta espezifikoak.Honela, agerian geratzen da egoiliarren balorazio integrala egitearen garrantzia eta ondorioz, zainketak indibidualizatu eta pertsonak osotasunean artatu behar direla

Sex Differences in Frailty Factors and Their Capacity to Identify Frailty in Older Adults Living in Long-Term Nursing Homes

Frailty is a phenomenon that precedes adverse health events in older people. However, there is currently no consensus for how to best measure frailty. Several studies report that women have a higher prevalence of frailty than men, but there is a gap in studies of the high rates of frailty in older people living in long-term nursing homes (LTNHs) stratified by sex. Therefore, we analyzed health parameters related to frailty and measured their capacity to identify frailty stratified by sex in older people living in LTNHs. According to the Fried Frailty Phenotype (FFP), anxiety increased the risk of frailty in women, while for men functionality protected against the risk of frailty. Regarding the Tilburg Frailty Indicator (TFI), functionality had a protective effect in men, while for women worse dynamic balance indicated a higher risk of frailty. The analyzed parameters had a similar capacity for detecting frailty measured by the TFI in both sexes, while the parameters differed in frailty measured by the FFP. Our study suggests that assessment of frailty in older adults should incorporate a broad definition of frailty that includes not only physical parameters but also psycho-affective aspects as measured by instruments such as the TFI.This research was funded by Gipuzkoako Foru Aldundia-Diputación Foral de Gipuzkoa (ADINBERRI DG18/25) and the Professional Association of Nurses of Gipuzkoa (COEGI Nursing Research Grants 2019–2020)

The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty

Among older adults living in long-term nursing homes (LTNHs), maintaining an adequate functional status and independence is a challenge. Whilst a poor nutritional status is a potential risk factor for a decreased function in this population, its role is not fully understood. Here, using a transversal multicenter study of 105 older adults living in 13 LTNHs, we analyzed the associations between nutritional status, as measured by the Mini Nutritional Assessment (MNA), and the parameters of functional status, physical performance, physical activity, and frailty as well as comorbidity and body composition. The MNA scores were positively correlated with the Barthel Index, handgrip strength, Short Physical Performance Battery (SPPB) scores, absolute muscle power, and Assessment of Physical Activity in Frail Older People (APAFOP) scores and were negatively correlated with dynamic balance and frailty. In a multiple linear regression model controlling for gender and age, the APAFOP score (β = 0.386), BMI (β = 0.301), and Barthel Index (β = 0.220) explained 31% of the variance in the MNA score. Given the observed close relationship between the MNA score and functional status, physical performance and activity, and frailty, interventions should jointly target improvements in both the nutritional status and functional status of LTNH residents. Strategies designed and implemented by interdisciplinary professional teams may be the most successful in improving these parameters to lead to better health and quality of life.This research was funded by Diputación Foral de Gipuzkoa (ADINBERRI DG18/25) and the Professional Association of Nurses of Gipuzkoa (COEGI Nursing Research Grants 2019)

Low Serum Klotho Concentration is Associated with Worse Cognition, Psychological Components of Frailty, Dependence, and Falls in Nursing Home Residents

Serum alpha-klotho (s-klotho) protein has been linked with lifespan, and low concentrations of s-klotho have been associated with worse physical and cognitive outcomes. Although its significance in aging remains unclear, s-klotho has been proposed as a molecular biomarker of frailty and dependence. This study is a secondary analysis of data from a clinical trial performed in a population of 103 older individuals living in 10 nursing homes in Gipuzkoa (Spain). We aimed to elucidate associations between s-klotho (as measured by enzyme-linked immunosorbent assay) and body composition, physical fitness, and cognition, as well as frailty and dependence (determined using validated tests and scales). In addition, we investigated the association of s-klotho concentration with falls in the six months following the initial assessment. Low s-klotho levels were associated with a lower score in the psychological component of the Tilburg Frailty Indicator, a worse score in the Coding Wechsler Adult Intelligence Scale, and a greater dependence in activities of daily living. Moreover, participants with lower s-klotho concentrations suffered more falls during the 6 months after the assessment. Future translational research should aim to validate klotho's putative role as a biomarker that could identify the risk of aging-related adverse events in clinical practice.This work was supported by grants from the Basque government (ELKARTEK15/39, ELKARTEK16/57, ELKARTEK17/61, RIS16/07, SAN17/11), the Euskampus Fundazioa Foundation, and the Convention between UPV/EHU and the Gipuzkoa Provincial Council (Gipuzkoa Eraikiz). Haritz Arrieta and Chloe Rezola were supported by two fellowships from the University of the Basque Country (UPV/EHU