Previous falls and risk of falls in relation to fragility

Esta investigación descriptiva transversal estudia la relación entre el número de caídas durante el último mes y el riesgo de caídas de una parte; y la situación de fragilidad en adultos mayores de otra parte; en una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las caídas previas durante el último mes se recogen de manera numérica y el riesgo de caídas se mide mediante la escala Downton. Los resultados no muestran diferencias significativas entre los grupos de fragilidad en relación al número de caídas previas durante el último mes. Sin embargo, sí que existen diferencias significativas entre los grupos de fragilidad que establece el SPPB y el riesgo de caídas; así, ya desde los resultados descriptivos se observa como las medias obtenidas en riesgo de caídas aumentan según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. En relación a las diferencias entre grupos, se encuentra que el grupo dependiente tiene diferencias significativas con todos los demás (p=,001); además, existen diferencias significativas entre frágil y robusto (p=,003). Por el contrario en las relaciones frágil-prefrágil y prefrágil-robusto las diferencias no son significativas. Los resultados obtenidos permiten la detección de la población con mayor riesgo de caídas, lo que posibilitaría implementar intervenciones precoces encaminadas a la prevención de caídas en base a las diferencias encontradas entre los grupos.This descriptive transversal research studies the relationship between number of falls in the last month and fall risk on one side; and frailty situation in older adults on the other side; through a 194 old institutionalized people sample. Frailty is measured with the Short Physical Performance Battery; previous falls in the last month are measured with the number of events, and fall risk with Downton scale. The results do not show any significant differences in frailty groups related to the number of previous falls in the last month. However, significant differences do exist between frailty groups established in SPPB and fall risk; then, since descriptive results, they show how the arithmetical averages in fall risk increase as the continuum robust-prefrail-frail-dependent advances towards dependency. Concerning differences between groups, it is found that dependent group has got significant differences with all other (p=,001), there are significant differences also in frail-robust (p=,003). In opposition, the relation frail-prefrail and frail-robust do not show any significant differences Results allow the detection of high level fall risk population, which enables early intervention implementations aimed to falls prevention based on differences found between groups.peerReviewe

Basic and instrumental activities in relation to the situation of fragility

Esta investigación descriptiva transversal estudia la relación de la situación de fragilidad en adultos mayores y la existencia o no de dependencia para las actividades de la vida diaria divididas en básicas e instrumentales con una muestra de 194 personas mayores institucionalizadas. La fragilidad se mide con la herramienta Short Physical Performance Battery, las actividades básicas de la vida diaria mediante el Índice de Barthel y las actividades instrumentales de la vida diaria con la escala de Lawton y Brody. Los resultados descriptivos muestran como las medias obtenidas en ambas actividades de la vida diaria disminuyen según el continumm robusto-prefrágil-frágil-dependiente avanza hacia la dependencia. Las diferencias en todas las subescalas de la Short Phisical Performance Battery son significativas, al igual que en Barthel y Lawton y Brody (p<,001). En relación al Barthel y los grupos del SPPB se encuentra que todos los grupos obtienen diferencias significativas entre sí (,007>p>,001) excepto en la relación robusto-frágil, en el que las diferencias no son significativas. En cuanto Lawton y Brody las diferencias son significativas (,041>p>,001); exceptuando el caso de los grupos frágil y prefrágil. Las diferencias encontradas entre los grupos permiten un diagnóstico precoz e intervenciones encaminadas a la prevenir o revertir el avance hacia una situación de dependencia.This descriptive transversal research studies frailty situation in older adults and basic and instrumental activities of daily living relationship through a 194 old institucionalized people sample. Frailty is measured with the Short Physical Performance Battery; basic activities of daily living with Barthel Index and instrumental activities of daily living with Lawton and Brody scale. Descriptive results show how the arithmetical averages in both activities of daily living decrease as the continuum robust-prefrail-frail-dependent advances towards dependency. There are significant differences in all subscales of Short Physical Performance Battery, as well as in Barthel and Lawton and Brody (p<,001). Regarding to Barthel and SPPB groups, significant differences among all of them were found (,007>p>,001), except in the robust-prefrail relation, where differences are not meaningful. Concerning Lawton and Brody, differences are significant (,041>p>,001); except in fragil-prefrail relation. The differences found between groups allow an early diagnosis and interventions aimed to prevent or reverse the progress towards a dependency situation.peerReviewe

Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington’s Disease: A Cross-Sectional Multicentre Study

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington’s disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.The project leading to these results has received funding from “La Caixa” Foundation (ID100010434), under agreement FUI1-PI008

Assistive Devices for Personal Mobility in Parkinson's Disease: A Systematic Review of the Literature

Artículo de revisiónGait abnormalities are a hallmark of Parkinson’s disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment.This work was supported by the project PI19/00670 of the Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Spain. The authors declare that there are no additional disclosures to report relevant to this work

Association Between Insulin‐Like Growth Factor‐1 and Social Cognition in Huntington's Disease

Insulin-like growth factor 1 (IGF-1) seems to be involved in the neural circuits associated with social cognition and brain structure.Study funded by Gerencia Regional de Salud de Castilla y Leon (Sacyl GRS 1768/A/18)

Estudio de modificadores ambientales epigenéticos asociados a la progresión de la Enfermedad de Huntington, y su relación con la apatía. Aplicaciones socioeducativas prácticas para la terapia ocupacional

La presente tesis doctoral titulada “Estudio de modificadores ambientales epigenéticos asociados a la progresión de la Enfermedad de Huntington, y su relación con la apatía. Aplicaciones prácticas para la terapia ocupacional”, sigue la modalidad de compendio de publicaciones. La enfermedad de Huntington (EH) es una enfermedad neurodegenerativa autosómica dominante, caracterizada por la progresión de los síntomas motores, deterioro cognitivo y aparición de síntomas neuropsiquiátricos. El curso clínico de esta enfermedad presenta un comienzo insidioso en la edad adulta, generalmente en torno a los 40 años, con un diagnóstico curso de 15-20 años hasta la muerte. Cabe señalar que las personas no fallecen como consecuencia directa de la EH, sino por problemas médicos subyacentes. Se conoce que, diferentes factores como son la actividad física, el sueño o la dieta, influyen en la progresión de la enfermedad. Por esto, el objetivo principal es evaluar la influencia de los modificadores ambientales sobre factores intrínsecos en la progresión de la EH y su relación con la apatía.This PhD entitled "Study of epigenetic environmental modifiers associated with the progression of Huntington's disease, and its relationship with apathy. Practical applications for occupational therapy", is a compendium of publications. Huntington's disease (HD) is an autosomal dominant neurodegenerative disease, characterised by the progression of motor symptoms, cognitive impairment and the appearance of neuropsychiatric symptoms. The clinical course of this disease has an insidious onset in adulthood, usually around the age of 40, with a diagnostic course of 15-20 years until death. It should be pointed out that people do not die as a direct consequence of HD, but from underlying medical problems. Different factors, such as physical activity, sleep and diet, are known to influence the progression of the disease. Therefore, the main objective is to assess the influence of environmental modifiers on intrinsic factors in HD progression and their relationship with apathy