Identifier: TDX:618
Authors: Juàrez Laiz, M. Mar
Abstract:
INTRODUCTION: The aging of the population is a known fact that will be maintained according to the WHO in the coming decades. Aging is associated with degenerative and pathological processes that frequently cause dependency on other persons. The aged are the population group that most frequently consults and that uses the greatest number of the health services. The best indicator of the health of this group is the functional state and the best way of evaluating it is through Integral Geriatric Assessment.OBJECTIVES: To determine the health problems of older people. To evaluate their quality of life and functional state. To know the accessibility, use, and frequentation of the health services. To analyze the factors with a greater predictive power of incapacitation. METODOLOGY: Transversal descriptive study. Population: all subjects older than 65 years of age in the city of Valls (Catalonia, Spain), according to the 2001 city census. Sample: 322 subjects, based on an randomized sample stratified by age and sex. Period of study:1 January 2002 to 30 April 2003. Integral Geriatric Assessment via the author's own questionnaire, specific evaluation instruments, and physical examination of all the subjects of the sample. Descriptive statistical and associational study of the different variables and multivariate analysis to verify the effect of different factors on the independent variables studied. RESULTS: 270 individuals. Participation: 83.8%. Sample fraction: 8.5%. 59.2% are women. 75.7 average age. 64.2% of the men live with a partner. The women more frequently live alone. 3.3% alternate 'residences.' 79.3% have finished primary school and 9.9% of the women are illiterate. 45.2% declare earnings of 300-600 /month, 45.9% more than 600 /month and 8.9% less than 300 /month. The men declare higher earnings than the women. Retirement or widows' pensions are the most frequent source of income (92.2%). 81.1% have autonomous access to the health services. 8.2% are included in a program of domiciliary health care. Variables associated with hyperfrequentation are: Level of education, recurrent falls, frequent hospitalization, habitual exercise and having AHT and dyslipemia.The most frequent pathologies are osteoarticular (46%) in women and cardiovascular in men (33%). Globally, the medicines with highest consumption are antihypertensives, benzodiazepines in women and antiaggregants in men. The most frequent geriatric syndromes are: urinary incontinence (45.6%), falls (40%), hearing loss (32.8%), constipation (31.9%) and polypharmacological treatment (26.2%). Consumption of analgesics has an OR=4, for urinary incontinence. Being a woman (OR=3), polypharmacological treatment (OR= 2) and functional dependence (OR=3.6), are risk factors for recurrent falls. Articular pathology (OR=2.4) and consumption of benzodiazepines (OR=2.4), are associated with constipation. Risk factors for polypharmacological treatment: falls (OR=2.2), lack of social support and hospitalization (OR=3.7). 10% of seniors suffer cognitive deterioration. Factors with predictive value are: age (OR=1.1) and functional dependence (OR=3.7). Depression is more frequent in women. Risk factors: benzodiazepine consumption (OR=6.4), functional dependence (OR=4.1) little social support (OR=5). Functional capacity declines from the age of 75 years, age is the factor with greatest influence (OR=1.2). Quality of life is globally good. Depression is the variable with the greatest predictive valule on its loss in men (OR=23.4). In women, these are depression (OR=22.7), and variables related to functional capacity, which are the main factors of risk of loss of CV.CONCLUSIONS: Geriatric assessment in people older than 75 should be a habitual activity in primary treatment. We would diagnose more and better if we improved the recording of pathologies and risk factors and adapted treatment to real needs. This would lead to greater attention pressure which would need to take into account the organization of the different activities carried out in primary treatment.
Repositori URV