Anxiety, depression, loneliness and social network among middle-aged and older people: longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA)

Background Social network, loneliness, generalized anxiety disorder (GAD) and major depression disorder (MDD) are interrelated. However, as the directions of these associations are still unclear, we examined them prospectively using community-based data. Methods Data on 5066 adults aged ≥50 years from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Loneliness was assessed through the UCLA loneliness scale. Social integration was measured using the Berkman-Syme Social Network Index. MDD and GAD were assessed with the Composite International Diagnostic Interview (CIDI). Logistic regression models were conducted. Results The longitudinal association between experiencing loneliness and higher likelihood of suffering from MDD or GAD two years later is bidirectional but stronger with loneliness as origin, whereas the association between social isolation and higher likelihood of subsequent MDD or GAD as well as those between loneliness and subsequent deterioration of social integration are unidirectional. Conclusion Objective and perceived social isolation independently affect the probability of suffering from MDD or GAD whereas loneliness is a risk factor for the deterioration of social life, which highlights the need to address the subjective factors (such as loneliness) and objective factors (such as social network size) of social isolation in a complementary way in order to improve the mental health of the older adult population

Revisión de la evidencia científica sobre uso clínico del Trabecular Bone Score (TBS). Posiciones oficiales de la SEIOMM (2018)

La incorporación de nuevas aplicaciones tecnológicas en el campo médico conlleva un prolongado periodo de valoración de la evidencia científica que se va generando en el proceso de validación clínica. En los últimos 5 años se han generado múltiples publicaciones, comunicaciones en congresos y reuniones de sociedades científicas. La aplicación del Trabecular Bone Score (TBS) ha recibido también la atención de la Sociedad Internacional de Densitometría Clínica (The International Society for Clinical Densitometry -ISCD-) que la ha incorporado a sus posiciones oficiales

A Prospective Open-Label Observational Study of a Buffered Soluble 70 mg Alendronate Effervescent Tableton Upper Gastrointestinal Safety and Medication Errors: The GastroPASS Study

Upper gastrointestinal (GI) side effects are a main reason for discontinuing bisphosphonate treatment, an important therapeuticoption for osteoporosis patients. Consequently, the development of novel formulations with improved tolerability is warranted. Inthis multicenter prospective, observational, postauthorization safety study conducted in Italy and Spain, postmenopausal women(PMW) with osteoporosis (naïve to bisphosphonates) were treated weekly with a buffered soluble alendronate 70 mg effervescent(ALN-EFF) tablet (Binosto®) and followed for 12 3 months. Information was collected on adverse events (AEs), medication errors,persistence, and compliance using the Morisky-Green questionnaire. Patients (N = 1028) aged 67 9 years (mean SD) receivedALN-EFF weekly. The cumulative incidence of upper GI AEs (oesophageal toxicity, gastritis, gastric ulcers, and duodenitis) relatedto ALN-EFF (primary endpoint) was 9.6% (95% condence interval [CI] 7.9–11.6%), the vast majority being of mild intensity. The mostfrequently occurring upper GI AEs related to ALN-EFF were dyspepsia (2.7%), gastroesophageal reux disease (2.4%), and nausea(2.2%). None of the relevant upper GI AEs listed in the primary endpoint and no serious AEs were reported. At least one medicationerror occurred in 29.9% (95% CI 27.1–32.8%) of patients. However, the majority of medication errors were associated with adminis-tration instructions applicable to any oral bisphosphonate and only seven medication errors were associated with the ALN-EFF for-mulation. ALN-EFF was discontinued in 209 of 1028 (20.3%) patients. The most frequent reasons for discontinuation were AEsrelated to ALN-EFF (46.9%) and patients’ decision (42.6%). Compliance with ALN-EFF was high, reected by a mean Morisky-Greenscore of 92.8 18.6. PMW with osteoporosis treated with ALN-EFF in a real-world setting experienced few upper GI AEs. In addition,they had a low discontinuation and high compliance compared with other formulations, suggesting that ALN-EFF may increasepatient satisfaction and therefore long-term adherence and efcac

Loneliness and depression in the elderly: the role of social network

PURPOSE: Loneliness and depression are associated, in particular in older adults. Less is known about the role of social networks in this relationship. The present study analyzes the influence of social networks in the relationship between loneliness and depression in the older adult population in Spain. METHODS: A population-representative sample of 3535 adults aged 50 years and over from Spain was analyzed. Loneliness was assessed by means of the three-item UCLA Loneliness Scale. Social network characteristics were measured using the Berkman-Syme Social Network Index. Major depression in the previous 12 months was assessed with the Composite International Diagnostic Interview (CIDI). Logistic regression models were used to analyze the survey data. RESULTS: Feelings of loneliness were more prevalent in women, those who were younger (50-65), single, separated, divorced or widowed, living in a rural setting, with a lower frequency of social interactions and smaller social network, and with major depression. Among people feeling lonely, those with depression were more frequently married and had a small social network. Among those not feeling lonely, depression was associated with being previously married. In depressed people, feelings of loneliness were associated with having a small social network; while among those without depression, feelings of loneliness were associated with being married. CONCLUSION: The type and size of social networks have a role in the relationship between loneliness and depression. Increasing social interaction may be more beneficial than strategies based on improving maladaptive social cognition in loneliness to reduce the prevalence of depression among Spanish older adults

Reumataxi: una experiencia solidaria en tiempos de COVID-19

Data de publicació electrónica: 24-04-202

Anxiety, depression, loneliness and social network among middle-aged and older people: longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA)

Background Social network, loneliness, generalized anxiety disorder (GAD) and major depression disorder (MDD) are interrelated. However, as the directions of these associations are still unclear, we examined them prospectively using community-based data. Methods Data on 5066 adults aged ≥50 years from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Loneliness was assessed through the UCLA loneliness scale. Social integration was measured using the Berkman-Syme Social Network Index. MDD and GAD were assessed with the Composite International Diagnostic Interview (CIDI). Logistic regression models were conducted. Results The longitudinal association between experiencing loneliness and higher likelihood of suffering from MDD or GAD two years later is bidirectional but stronger with loneliness as origin, whereas the association between social isolation and higher likelihood of subsequent MDD or GAD as well as those between loneliness and subsequent deterioration of social integration are unidirectional. Conclusion Objective and perceived social isolation independently affect the probability of suffering from MDD or GAD whereas loneliness is a risk factor for the deterioration of social life, which highlights the need to address the subjective factors (such as loneliness) and objective factors (such as social network size) of social isolation in a complementary way in order to improve the mental health of the older adult population

Multidisciplinary expert consensus on secondary fracture prevention in Spain

The study aimed to achieve expert consensus to optimize secondary fracture prevention in Spain. Relevant gaps in current patient management were identified. However, some aspects were considered difficult to apply. Future efforts should focus on those items with greatest divergences between importance and feasibility. Purpose: To establish a Spanish multidisciplinary expert consensus on secondary fracture prevention. Methods: A two-round Delphi consensus was conducted, guided by a Scientific Committee. The 43-item study questionnaire was designed from a literature review and a subsequent multidisciplinary expert group (n = 12) discussion. The first-round questionnaire, using a 7-point Likert scale, assessed the experts' opinion of the current situation, their wish for items to happen, and their prognosis that items would be implemented within 5 years. Items for which consensus was not achieved were included in the second round. Consensus was defined as ≥ 75% agreement or ≥ 75% disagreement. A total of 102 experts from 14 scientific societies were invited to participate. Results: A total of 75 (response rate 73.5%) and 69 (92.0%) experts answered the first and second Delphi rounds, respectively. Participants mean age was 51.8 years [standard deviation (SD): 10.1 years]; being 24.0% rheumatologists, 21.3% primary care physicians, 14.7% geriatricians, 8.0% internal medicine specialists, 8.0% rehabilitation physicians, and 8.0% gynecologists. Consensus was achieved for 79.1% of items (wish, 100%; prognosis, 58.1%). Effective secondary prevention strategies identified as requiring improvement included: clinical report standardization, effective hospital primary care communication (telephone/mail and case managers), health-related quality of life (HRQoL) questionnaires use, and treatment compliance monitoring (prognosis agreement 33.3%, 47.8%, 18.8%, and 55.1%, respectively). Conclusion: A consensus was reached by health professionals in their wish to implement strategies to optimize secondary fracture prevention; however, they considered some difficult to apply. Efforts should focus on those items with currently low application and those with greatest divergence between wish and prognosis

A prospective open-label observational study of a buffered soluble 70 mg alendronate effervescent tablet on upper gastrointestinal safety and medication errors: The GastroPASS Study

Upper gastrointestinal (GI) side effects are a main reason for discontinuing bisphosphonate treatment, an important therapeutic option for osteoporosis patients. Consequently, the development of novel formulations with improved tolerability is warranted. In this multicenter prospective, observational, postauthorization safety study conducted in Italy and Spain, postmenopausal women (PMW) with osteoporosis (naïve to bisphosphonates) were treated weekly with a buffered soluble alendronate 70 mg effervescent (ALN-EFF) tablet (Binosto®) and followed for 12 ± 3 months. Information was collected on adverse events (AEs), medication errors, persistence, and compliance using the Morisky-Green questionnaire. Patients (N = 1028) aged 67 ± 9 years (mean ± SD) received ALN-EFF weekly. The cumulative incidence of upper GI AEs (oesophageal toxicity, gastritis, gastric ulcers, and duodenitis) related to ALN-EFF (primary endpoint) was 9.6% (95% confidence interval [CI] 7.9-11.6%), the vast majority being of mild intensity. The most frequently occurring upper GI AEs related to ALN-EFF were dyspepsia (2.7%), gastroesophageal reflux disease (2.4%), and nausea (2.2%). None of the relevant upper GI AEs listed in the primary endpoint and no serious AEs were reported. At least one medication error occurred in 29.9% (95% CI 27.1-32.8%) of patients. However, the majority of medication errors were associated with administration instructions applicable to any oral bisphosphonate and only seven medication errors were associated with the ALN-EFF formulation. ALN-EFF was discontinued in 209 of 1028 (20.3%) patients. The most frequent reasons for discontinuation were AEs related to ALN-EFF (46.9%) and patients' decision (42.6%). Compliance with ALN-EFF was high, reflected by a mean Morisky-Green score of 92.8 ± 18.6. PMW with osteoporosis treated with ALN-EFF in a real-world setting experienced few upper GI AEs. In addition, they had a low discontinuation and high compliance compared with other formulations, suggesting that ALN-EFF may increase patient satisfaction and therefore long-term adherence and efficacy. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research

Screening for the presence of FMR1 premutation alleles in women with fibromyalgia.

peer reviewedFibromyalgia is a chronic condition characterized by widespread pain, fatigue, non-restorative sleep and cognitive difficulties that affects 2-4% of the general population. Recently a possible relationship between the FMR1 premutation and fibromyalgia has been pointed out. In attempt to gather more data we screened for the FMR1 CGG expansion 700 DNA samples from unrelated fibromyalgia patients. This data might be useful for evaluating the incorporation of this test in rheumatologic procedures for women with fibromyalgia. The observed frequency of FMR1 premutation carriers (3 of 700, 0.4%) is not significantly different from the estimated rate in the general female population (1/250-1/400) (P=0.539, P=0.716). Clinical examination of the FMR1 premutation carriers identified revealed that all of them had important neurological symptoms with regard to muscular symptoms, neurocognitive alterations and neurovegetative impairments. With regard to other clinical aspects of the disease the cases apparently did not differ from the average fibromyalgia patients. On the basis of our results an FMR1 screening among fibromyalgia female patients would not be recommended. However it would be worthwhile to further evaluate the different clinical presentations that fibromyalgia patients might present based on their FMR1 premutation carrier status