Search

Alzheimer’s disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD.

Introduction: The presence of comorbidities modulates the aging process, the diagnosis of cancer can significantly compromise the health of the elderly, which affects their quality of life. Objective: Determine the association between the functional dependence and the quality of life in elderly oncology patients treated with radiotherapy. Methods: Retrospective analytical study, carried out in 181 outpatients of Centro Médico Naval del Callao, Perú, male, older than 60 years. The functional dependence was assessed with Barthel index and Lawton scale; and the quality of life was assessed with World Health Organization Quality of Life-Older Adults Module (WHOQoL-Old). Results: A statistically significant association was found between functional dependence and quality of life, for both the basic activities of daily living (PR= 1.04 [IC 95 %: 1.01-1.07]), and the instrumental activities of daily living (PR= 1.08 [IC 95 %: 1.01 - 1.13]). Conclusion: There was significant association between the functional dependence and the poor quality of life in the elderly oncology patients treated with radiotherapy.

ObjectiveTo evaluate the role of cognitive frailty and its components as risk factors of mortality in older adults of the Centro Médico Naval (CEMENA) in Callao, Peru during 2010-2015.MethodsWe performed a secondary analysis of data from a prospective cohort that included older adults (60 years and older) treated at the CEMENA Geriatrics service between 2010–2015. Frailty was defined as the presence of three or more criteria of the modified Fried Phenotype. Cognitive impairment was assessed using the Peruvian version of the Mini Mental State Examination (MMSE), considering a score

Abstract Background Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. Methods In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

To determine the association between tobacco consumption and self-reported visual impairment. We performed a cross-sectional study based on an original cohort study. A non-probabilistic sampling was performed to invite 413 patients of 60 years or more from 11 high-altitude Andean communities (altitude higher than 1500 m above sea level) of Peru between 2013 and 2017. Demographic data and information on tobacco consumption were collected. Associations were determined using a Poisson regression model with 95% confidence intervals (CI). Of the 413 participants, 141 (34.14%) were men and 49 (11.86%) were tobacco users. In the adjusted model, tobacco users presented a high probability of visual impairment with a prevalence ratio of 1.32 (95% CI: 1.18–1.97). We also found that having two or more comorbidities 2.19 (95% CI: 1.53–3.15), receiving health assistance in a pharmacy 3.75 (95% CI: 1.97–7.16), and coffee consumption 1.67 (95% CI: 1.26–2.21) were factors significantly associated with self-reported visual impairment. We determined that in Peruvian high-altitude Andean communities, visual impairment was more frequent in individuals reporting tobacco consumption, taking alternative medicine, going directly to a drug store without primary care physician consultation, having more than one comorbidity, and coffee consumption.

Objetivo: determinar la relación entre albuminuria y mortalidad en adultos mayores con pie diabético atendidos en la Clínica de Día del Servicio de Geriatría del Centro Médico Naval del Perú “Cirujano Mayor Santiago Távara” en el periodo 2010-2015. Materiales y Métodos: estudio cuantitativo, observacional, analítico, cohorte retrospectiva. Se incluyeron datos de 89 pacientes adultos mayores, que cumplieron los criterios de selección. Se realizó un análisis descriptivo incluyendo las principales variables como fallecimiento durante el estudio, comorbilidades y variables sociodemográficas. Posteriormente, se hizo un análisis bivariado en base a supervivencia al final del estudio donde se analizaron todas las covariables en base a la variable principal del estudio (mortalidad). Resultados: la edad promedio fue de 79,3 ± 7,2 años con predominancia del sexo masculino (58,4%), encontramos que 52 participantes (58,4%) tenían antecedentes de albuminuria y que el 7,9% de la población falleció durante el estudio, de los cuales el 100% presentaba albuminuria. Finalmente, al igual que en el caso de albuminuria, todos los pacientes con antecedente de amputación por pie diabético fallecieron durante el seguimiento. Conclusión: se encontró relación significativa entre la presencia de albuminuria y mortalidad en los adultos mayores con pie diabético incluidos en el estudio.

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented. Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55). Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

The fast aging of population, epidemiological changes and the need to guarantee human rights (health, social protection,etc.) force countries and the wider community to become aware and develop policies that form the basis for an strategy of maintaining the health and care of elderly people. This should be designed taking into account the particularities of this age group, and the need for adaptation of social health services to provide quality care and equity. The adequacy of services involves recognizing the new requirements, the particularities of the risks and problems of this stage of life, comprehensive care, and even decent evidence-based on the end of life. In the presence of new problems and new goals, new skills, new work scenarios and an information system that improve the efficiency and quality of interventions are required

An amendment to this paper has been published and can be accessed via the original article.