Estado nutricional de los ancianos institucionalizados en residencias de mayores de la provincia de Albacete

Esta tesis tiene como objetivo principal el estudio del estado nutricional de los ancianos institucionalizados en las residencias de mayores de la provincia de Albacete, determinado su prevalencia y analizando su distribución en función de la edad, el sexo y las diferentes características de las residencias, usando como instrumento de valoración el test MNA. Un total de 895 personas (523 mujeres y 372 hombres) con edad igual o superior a 65 años, sin deterioro cognitivo grave y residentes en la práctica totalidad de las residencias de mayores de la provincia participaron en el estudio. Se obtuvo una prevalencia de malnutrición del 2.8% y una prevalencia de riesgo de malnutrición del 37.3%, siendo el sexo femenino y residir en instituciones ubicadas en la capital factores de riesgo de malnutrición, sin encontrar diferencias significativas en el estado nutricional de los residentes cuando se consideraron como variables la capacidad, el tipo de financiación o el carácter secular/religioso de las residencias. En general, se detectó un aumento de los índices de malnutrición y riesgo de malnutrición con la edad. El análisis de las cuestiones del MNA con mayor impacto sobre el resultado final del test reveló como tales aquéllas relativas a la valoración antropométrica y a la autopercepción del estado nutricional y de salud de los residentes, siendo la pérdida de peso y la movilidad los más importantes. Por otra parte, las cuestiones con menos influencia sobre el resultado final del MNA fueron aquéllas relacionadas directamente con la valoración dietética. Por otra parte, se estudió el valor del MNA como predictor del estado funcional de los residentes (determinado por las puntuaciones del test del Barthel (IB)). El estudio de las correlaciones mostró que MNA y el IB estaban positivamente asociados (r=0.375, p<0.001). Se obtuvieron puntos de corte para IB que permitieron establecer un sistema de clasificación en tres grupos para el IB de acuerdo con las correspondientes tres categorías del MNA (el MNA discrimina entre individuos con IB¿40, aquéllos con IB entre 45 y 85 y los que alcanzan un IB¿86). El MNA se mostró como un buen predictor del estado funcional en ancianos institucionalizados en residencias de mayores de la provincia, siendo movilidad, forma de alimentarse, autopercepción de salud y circunferencia braquial los ítems del MNA positivamente asociados con la dependencia funcional según el IB. Finalmente, en esta tesis contribuyó a la validación de las nuevas formas revisadas de la versión corta del MNA (MNA-SF), a saber, BMI-MNA-SF y CC-MNA-SF, en la población española institucionalizada. Se encontró una alta correlación entre el MNA y las MNA-SFs (r=0.904, p<0.001 para el BMI-MNA-SF y r=0.864, p<0.001 para el CC-MNA-SF), valores altos de sensibilidad, especificidad, valores predictivos positivo y negativo y áreas bajo las correspondientes curvas ROC, así como altos niveles de concordancia de estas formas con el MNA. Ambos test se sugieren como herramientas rápidas, sencillas de implementar y fiables, capaces de diferenciar entre individuos malnutridos, en riesgo de malnutrición y bien nutridos con mínimos errores de clasificación

Fiber Patterns in Young Adults Living in Different Environments (USA, Spain, and Tunisia). Anthropometric and Lifestyle Characteristics

Benefits of dietary fiber go beyond its effect on chronic diseases associated with development. Consequently, the pattern of fiber intake has been considered an indicator for diet quality. Young adults are especially vulnerable to a food environment that drives an increase in chronic diseases linked to economic development. The aim of this work was to characterize patterns of fiber intake among university students. A cross-sectional study was conducted on a sample of 730 students enrolled at the University of Castilla-La Mancha (Spain), the University of Carthage (Tunisia), and Florida International University (USA). Mean age was 21.2. Food consumption was self-reported in two 24-h recalls. Mean dietary fiber intake was 17.8 g, not reaching the adequate intake. Contrary to expectations, American participants were the highest consumers (p &lt; 0.001), and also exhibited the highest BMI. Cereals, legumes, vegetables and fruit were the main food sources of fiber. Fiber from appetizers, prepared and precooked meals, sauces, spices and condiments accounted for 16.7% in American participants, 7.4% in Spanish participants and 2.6% in Tunisian participants. Total fiber intake increased with energy intake but did not depend on smoking habits and physical activity in any country. It is essential to improve consumers’ interpretation of guidelines on fiber intake

Patrones de desayuno en estudiantes universitarios de España, Túnez y Estados Unidos. Factores antropométricos, sociodemográficos y de estilo de vida

La mayor&iacute;a de los estudios apoyan la tesis de que el desayuno es la comida m&aacute;s importante del d&iacute;a. Un desayuno adecuado contribuye a lograr un patr&oacute;n diet&eacute;tico global saludable y a mejorar la calidad de la dieta. El objetivo de este estudio fue determinar los principales patrones de desayuno en tres poblaciones universitarias de Espa&ntilde;a, T&uacute;nez y Estados Unidos, analizar sus semejanzas y diferencias y estudiar la influencia de factores antropom&eacute;tricos, sociodemogr&aacute;ficos y de estilo de vida en la adherencia a cada patr&oacute;n. Se realiz&oacute; un estudio transversal con datos de 730 estudiantes matriculados en las Universidades de Castilla-La Mancha, Cartago e Internacional de Florida en 2013. El consumo de alimentos se obtuvo mediante dos recordatorios de 24 horas, no consecutivos, uno de ellos en fin de semana. Los patrones se identificaron mediante an&aacute;lisis factorial exploratorio. La adherencia de los estudiantes a cada patr&oacute;n se evalu&oacute; usando las puntuaciones factoriales. Se obtuvieron cuatro patrones para cada pa&iacute;s. El principal patr&oacute;n de los universitarios espa&ntilde;oles incluy&oacute; pan, tomate, sal y aceite de oliva (varianza explicada: 20,85%); el principal de los tunecinos conten&iacute;a pan, mermelada, nata y mantequilla (varianza explicada: 12,73%) y el principal de los americanos incluy&oacute; huevos, leche entera y az&uacute;cares (varianza explicada: 10,77%). G&eacute;nero, peso, IMC o comer fuera de casa fueron factores que influyeron en la adherencia a diferentes patrones. El estudio mostr&oacute; la coexistencia de patrones tradicionales con otros occidentalizados y modelos transicionales intermedios. No se determin&oacute; un patr&oacute;n generalizable asociado a mejores resultados del IMC.Most studies support the conclusion that breakfast is the most important meal of the day. An adequate breakfast contributes to achieving a healthy global dietary pattern and improving quality of diet. The objective of this study was to determine the main breakfast patterns of three university populations from Spain, Tunisia, and The United States of America, analyze their similarities and differences, and study the impact of anthropometric, sociodemographic and lifestyle factors on the adherence to each pattern. A cross-sectional study was developed with data from 730 students enrolled at the University of Castilla-La Mancha, University of Carthage, and Florida International University, during 2013. Food consumption data were obtained by means of two non-consecutive 24-hour recalls including one weekend day. Exploratory factor analysis was conducted to identify breakfast patterns. Factor scores were used to assess students&rsquo; adherence to each pattern. Four breakfast patterns were obtained for each country. The main pattern of the Spanish students included bread, tomato, salt, and olive oil (explained variance: 20.85%); the main model of the Tunisians included bread, jam, cream and butter (explained variance: 12.73%); and the first pattern of the Americans was characterized by eggs, whole milk and sugars (explained variance: 10.77%). Gender, weight, BMI or eating out of home were factors that influenced the adherence to different patterns. Breakfast patterns obtained in this work showed the coexistence of traditional models with westernized and transitional ones. It was not determined a generalizable pattern associated with better BMI results

Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis

<div><p>Background</p><p>High prevalence of functional limitations has been previously observed in nursing homes. Disability may depend not only on the characteristics of the residents but also on the facility characteristics. The aims of this study were: 1, to describe the prevalence of functional disability in older people living in Spanish nursing homes; and 2, to analyze the relationships between individual and nursing home characteristics and residents’ functional disability.</p><p>Methods</p><p>A cross-sectional study with data collected from 895 residents in 34 nursing homes in the province of Albacete (Spain) was conducted. Functional status was assessed by the Barthel Index. Taking into account both levels of data (individual and institutional characteristics) we resorted to a multilevel analysis in order to take different sources of variability in the data.</p><p>Results</p><p>The prevalence of functional disability of the total sample was 79.8%. The best fitting multilevel model showed that female gender, older age, negative self-perception of health, and living in private nursing homes were factors significantly associated with functional disability. After separating individual and institutional effects, the institutions showed significant differences.</p><p>Conclusions</p><p>In line with previous findings, our study found high levels of functional dependence among institutionalized elders. Gender, age, self-perception of health, and institution ownership were associated with functional status. Disentangling individual and institutional effects by means of multilevel models can help evaluate the quality of the residences.</p></div

Distribution of the elderly population participating in the survey and distribution of BI scores.

<p>Distribution of the elderly population participating in the survey and distribution of BI scores.</p

Results for the four multilevel models fitted to the data in the study.

<p>Results for the four multilevel models fitted to the data in the study.</p

Time trends in antibiotic consumption in the elderly: Ten-year follow-up of the Spanish National Health Survey and the European Health Interview Survey for Spain (2003–2014)

<div><p>Background</p><p>The purposes of this study were: firstly, to estimate time trends in the prevalence of prescription antibiotic consumption between 2003 and 2014; secondly, to identify the factors associated with the probability of consuming antibiotics during this period in elderly persons in Spain.</p><p>Methods</p><p>We analyzed data collected from the Spanish National Health Survey in 2003 (n = 21,650), 2006 (n = 29,478), and 2012 (n = 20,007) and from the European Health Interview Survey for Spain in 2009 (n = 22,188) and 2014 (n = 22,842). Antibiotic consumption was the dependent variable. We also analyzed sociodemographic features, self-perceived health status, lifestyle habits, comorbid diseases, and disabilities using logistic regression models.</p><p>Results</p><p>The prevalence of antibiotic consumption increased from 2003 to 2014 in both sexes. The variables that predicted antibiotic consumption (men; women) were secondary education (OR 1.38; OR 1.31), visits to a general practitioner (OR 2.05; OR 2.15), hospitalization (OR 1.91; OR 1.83), therapy with > 4 non-antibiotic drugs (OR 3.36; OR 5.84), instrumental activities of daily living (OR 1.50; OR 1.24), and activities of daily living (OR 1.39; OR 1.35). In contrast, age > 85 years was associated with low antibiotic consumption in both men (OR 0.81) and women (OR 0.88).</p><p>Conclusions</p><p>The prevalence of antibiotic prescription has increased in Spain in the last decade. Our study identified several factors that appear to affect antibiotic consumption in elderly persons, with potential implications for healthcare providers.</p></div

Factors associated with consumption of antibiotics by prescription in elderly persons aged ≥65 years in Spain.

<p>Spanish National Health Survey 2003–2006, 2012 and European Health Interview Survey 2009 and 2014 for Spain.</p

Prevalence of antibiotic consumption in Spanish elderly, according to sex and age groups.

<p>Spanish National Health Survey (SNHS) 2003–2006, 2012 and European Health Interview Survey (EHIS) 2009 and 2014 for Spain.</p