Cambios morfofisiológicos y riesgo de caídas en el adulto mayor: una revisión

El envejecimiento es un proceso universal, irreversible e individual que provoca cambios morfofisiológicos en los sistemas músculo-esquelético, sistema nervioso central y los sistemas sensoriales (visual, vestibular y propiocepción), ocasionando mayor riesgo de caídas. Las caídas tienen una alta prevalencia y se han transformado en un importante problema de salud pública debido a los altos costos económicos y funcionales que representan en el adulto mayor. Para evitar éstos eventos es importante conocer los cambios anatomofisiológicos asociados al envejecimiento y planear estrategias de salud en donde se incorpore estimulación ósea, muscular, somatosensorial (propioceptiva) y cognitiva con el propósito de evitar el deterioro funcional y la discapacidad. En base a lo anterior, el objetivo de esta revisión es exponer el conocimiento actual de los cambios morfofisiológicos involucrados en el riesgo de caídas del adulto mayor

Comparación de marcadores antropométricos de salud entre mujeres de 60-75 años físicamente activas e inactivas

Introduction: the objective of this study was to compare the anthropometric markers of health body mass index (BMI), waist circumference (WC) and body fat percentage (BFP) among physically active (PA) and physically inactive (PI) older women. Material and methods: cross-sectional descriptive study with 88 women aged 60-75 years old. The evaluations were carried out in the biomechanics laboratory of the Universidad Santo Tomás (Chile), and  included measurements of body weight, bipedal stature, CC and cutaneous folds. BMI (kg/m2) and percentage of GC were calculated from the skin folds. Results: PA older women presented significantly lower values than IF in the anthropometric health markers evaluated: percentage of CG (p = 0.01), BMI (p = 0.04) and WC (p = 0.03). However, both groups obtained CC and GC values above healthy recommendations. A BMI of 29.76 kg/m2 and 26.8 kg/m2 was obtained for PI and PA, respectively. According to these values, PI were classified as overweight, while PA were classified as normal. When comparing skinfolds, it was observed than PA had values significantly lower than PI in triceps (p=0.03), subscapular (p=0.005) and suprailiac (p=0.001) folds. Conclusions: older women with PA show favorable BMI, WC, and BFP with respect to PI, which could indicate that regular physical activity would be a beneficial element in the health of older adults.Introducción: El propósito de este estudio fue comparar los marcadores antropométricos de salud índice de masa corporal (IMC), circunferencia de cintura (CC) y porcentaje de grasa corporal (GC) entre mujeres mayores físicamente activas (FA) y físicamente inactivas (FI). Material y métodos: Estudio descriptivo transversal con 88 mujeres mayores entre 60 y 75 años. Las evaluaciones fueron realizadas en el laboratorio de biomecánica de la Universidad Santo Tomás (Chile) e incluyeron las mediciones de peso corporal, estatura bípeda, CC y pliegues cutáneos. Se calculó IMC (kg/m2) y porcentaje de GC a partir de los pliegues cutáneos.Resultados: Las comparaciones señalan que las mujeres mayores FA presentaron valores significativamente menores que las FI en los marcadores antropométricos de salud evaluados: porcentaje de GC (p= 0,01), IMC (p= 0,04) y CC (p= 0,03). Sin embargo, ambos grupos obtuvieron valores de CC y GC por encima de las recomendaciones saludables. En las FI se obtuvo un IMC de 29,7 kg/m2 y en las FA de 26,8 kg/m2. De acuerdo a estos valores, las FI se clasifican en la categoría de sobrepeso, mientras que las FA en normopeso. Al comparar los pliegues cutáneos se observó que las FA presentaron valores significativamente menores que las FI en pliegues tricipital (p = 0,033), subescapular (p = 0,005) y suprailíaco (p = 0,001). Conclusiones: Las mujeres mayores FA presentan IMC, CC y porcentaje de GC favorables respecto a sus pares FI, lo cual podría indicar que la práctica regular de actividad física sería un elemento beneficioso sobre la salud de los adultos mayores

Impacto de un contexto de pandemia sobre la calidad de vida de adultos jóvenes

Introducción: La cuarentena y el aislamiento social son las medidas más recomendadas por las autoridades de salud con el objetivo de reducir la interacción social entre las personas y disminuir el riesgo de contagio por la COVID-19 en la comunidad. Sin embargo, estas restricciones y limitaciones pueden traer consecuencias en la calidad de vida relacionada con la salud de adultos jóvenes. Objetivo: Comparar la calidad de vida autorreportada entre un entorno sin pandemia vs. un contexto bajo alerta sanitaria por la COVID-19, en adultos jóvenes. Métodos: Estudio retrospectivo; 157 adultos jóvenes (63 mujeres y 94 hombres), de entre 18 y 28 años, respondieron el cuestionario de salud SF-36 en 2 situaciones: contexto sin pandemia (septiembre de 2019) y contexto de pandemia (abril de 2020). El SF-36 incluye 36 preguntas agrupadas en 8 ítems: función física, rol físico, dolor corporal, salud general, vitalidad, función social, rol emocional y salud mental. Resultados: Al comparar las evaluaciones entre los contextos con y sin pandemia, se observó una disminución de la calidad de vida en las dimensiones vitalidad (p = 0,004), función social (p = 0,001), rol emocional (p = 0,001), salud mental (p = 0,003) y salud general (p = 0,001). Las dimensiones más alteradas fueron el rol emocional y la salud general, las cuales disminuyeron un 39,5 % y 21,0 %, respectivamente. Conclusión: La calidad de vida relacionada con la salud de adultos jóvenes se ve disminuida en un contexto de cuarentena por la COVID-19, principalmente, en las dimensiones psicológicas y sociales

Influencia del estado nutricional sobre el equilibrio postural en niños: un estudio piloto

Introducción: El aumento de masa corporal puede afectar la realización de tareas funcionales como el equilibrio y propiciar el riesgo de caídas y lesiones, sin embargo las pruebas en niños son limitadas. El propósito de este estudio fue determinar la influencia del estado nutricional sobre el equilibrio postural en niños entre 6 y 9 años de edad. Material y métodos: Estudio piloto descriptivo transversal. Se evaluaron 71 niños en cuanto a peso, talla y equilibrio medido con ojos abiertos (OA) y cerrados (OC) sobre una plataforma de fuerza. Se consideraron las variables del centro de presión (CP): área, velocidad media, velocidad mediolateral y velocidad anteroposterior. Se realizó una regresión lineal ajustando por sexo utilizando como variable respuesta las variables del CP y como variable explicativa el sobrepeso/obesidad frente a normopeso. Resultados: Los niños con sobrepeso/obesidad presentan mayores valores en las variables velocidad media OA (β = 0,018; p = 0,005), velocidad mediolateral OA (β = 0,122; p = 0,005), velocidad anteroposterior OA (β = 0,041; p  < 0,001), velocidad media OC (β = 0,009; p  < 0,001), velocidad mediolateral OC (β = 0,067; p  < 0,001) y velocidad anteroposterior OC del CP (β = 0,409; p  < 0,001). Además, se observaron correlaciones significativas entre el aumento del IMC y el deterioro del equilibrio postural (p < 0,05). Conclusión: Los niños con sobrepeso y obesidad situados entre 6 y 9 años presentan un equilibrio postural más bajo que los normopesos. Con los ojos cerrados, la variable sexo también influye en el control de la postura

Relationship between appendicular muscular mass index and physical function in older people

This study aimed to establish the relationship between the appendicular muscle mass index (AMMI), assessed from anthropometric variables, and the physical function of older people. Seventy-six older people participated in this study (72.03 ± 7.03 years). The participants underwent evaluations to determine their AMMI using anthropometry (weight, calf circumference, hip circumference, and knee height) and manual grip strength. Additionally, their physical function was evaluated using the 5-chair stand test, the 3-meter walk test, and the timed up and go test (TUG) to determine the strength of the lower limbs, the gait speed, and the dynamic balance, respectively. The results show that the AMMI did not present a significant relationship with the 5-chair stand test in both women (r = -0.135; p = 0.204) and men (r = -0.067; p = 0.349). The AMMI was moderately correlated with the gait speed in both women (r = 0.542; p < 0.001) and men (r = 0.556; p < 0.001). Finally, a statistical significance was observed in the relationship between the AMMI and the TUG test in women (r = -0.273; p = 0.047) and older men evaluated in this study (r = -0.284; p = 0.042). In conclusion, there is a relationship between the AMMI and both the dynamic balance and the gait speed. Therefore, the AMMI emerges as a potential public health assessment by enabling the clinical quantification of muscle mass and an estimation of physical function in the elderly population

Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults

Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009–2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others

Handgrip strength as a predictor of adverse health outcomes

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults

A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017

Abstract Objective: To investigate the relationship of a healthy eating score with depression in Chilean older adults. Design: Cross-sectional study. Setting: Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases). Participants: The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4). Results: Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %). Conclusion: Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population

Levels of physical activity and sitting time in elderly people with fragility: results of the 2016-2017 National Health Survey

Background: fragility is characterized by loss of biological reserves and vulnerability to adverse outcomes. An intervention with beneficial effects on the prevention and management of frailty is the regular practice of physical activity (PA). Objective: to determine the association between levels of PA, sedentary time and frailty in older Chileans by sex. Methodology: 232 people over 60 years of age from the metropolitan region participating in the National Health Survey 2016-2017 were included. Frailty was assessed based on the Fried Phenotype Scale criteria and PA level and sedentary time with the Global Physical Activity Questionnaire (GPAQ v2). The association between levels of PA with the different states of frailty was investigated with linear regression analysis. Results and conclusion: elderly people with frailty have less total PA (β =-292.6 min/day [95 % CI: 399.5;-185.7], p = 0.001), occupational PA (β =-5821.8 min/day [95 % CI: 8680.8,-2962.8], p = 0.001), transportation (β =-68.0 min/day [95 % CI:-105.4,-30.62], p = 0.001). A lower amount of moderate AF was also found (β =-137.7 min/day [95 % CI:-202.0,-73.5], p = 0.001); vigorous (β =-43.4 min/day [95 % CI:-81.6;-5.20], p = 0.026) and longer time seated (β = 3.55 hours/day [95 % CI:-1.97, 5.14], p = 0.001). Frail older people have lower PA levels compared to their peers without frailty. Considering that the Chilean population will experience an increase in the number of older people, it is essential to implement preventive measures to delay the onset of frailty, such as promoting the practice of PA at all levels.7 página