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Chenhuichen C, Marín-Epelde I, Ramón-Espinoza F, Sánchez-Latorre M, Gonzales Montejo NJ, Pozo Vico A, Librero López J, Casas-Herrero A. [Epidemiological, clinical, and functional characteristics of patients older than 75 years admitted to a tertiary hospital during the first wave of the SARS-CoV-2 pandemic]. Rev Esp Geriatr Gerontol 2024; 59:101449. [PMID: 38064873 DOI: 10.1016/j.regg.2023.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND The objective of the present study is to analyze the epidemiological, clinical and functional characteristics of patients admitted to the University Hospital of Navarra due to SARS-CoV-2 infection, as well as the predictors of mortality, during the first wave of the pandemic caused by this virus. METHODOLOGY An observational, retrospective study was performed, including all hospitalized patients older than 75 years. Information has been obtained on multiple variables, among which it is worth mentioning previous geriatric syndromes or those that have appeared during hospitalization, or past medical history considered relevant in SARS-CoV-2 infection. A descriptive analysis of the data, comparisons according to various factors of interest and multivariate analysis to analyze factors associated with mortality were carried out. RESULTS Data have been obtained from a total of 426 patients with a mean age of 83.2 years (52.6% men). 34.7% died in hospital and 4.5% within 1 month after hospital discharge. The factors related to mortality were: worse baseline functional status, chronic kidney disease, and fever or dyspnea as forms of presentation. The most frequent typical symptoms were: fever, dyspnea, cough, asthenia and hyporexia. Up to 42.1% presented delirium as a symptom of atypical onset. We observed a functional deterioration that was not recover after a month of follow-up (baseline Barthel index 81.12; 70.08 at discharge; 75.55 after a month). CONCLUSIONS SARS-CoV-2 infection has caused high mortality rates in older adults. In this age group, the atypical presentation of this disease and functional deterioration during hospitalization are frequent. In the present study, a worse previous functional status has been identified as a predictor of mortality. More studies are needed to evaluate the impact that the disease and hospitalization have on the older patient, with the aim of implementing preventive, diagnostic and therapeutic measures that are necessary to avoid functional deterioration and adverse health events related to it.
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Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | - Itxaso Marín-Epelde
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | | | - Marina Sánchez-Latorre
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | | | - Ana Pozo Vico
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | - Julián Librero López
- Biomedical Research Centre of the Government of Navarre (Navarrabiomed), , Pamplona, Navarra, España
| | - Alvaro Casas-Herrero
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España; Biomedical Research Centre of the Government of Navarre (Navarrabiomed), , Pamplona, Navarra, España; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, España; Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, España.
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Roncal-Belzunce V, Cedeño-Veloz BA, Elcano RSM, Gutiérrez-Valencia M, Izquieta VR, Guruceaga-Eguillor I, Marín-Epelde I, Echeverria-Beistegui I, Sánchez-Latorre M, Galbete A, Garaioa-Aramburu K, Martínez-Velilla N. Cognitive and functional trajectories in geriatric outpatients after a pharmacologic multidisciplinary intervention: A study protocol. Rev Esp Geriatr Gerontol 2023; 58:101386. [PMID: 37523939 DOI: 10.1016/j.regg.2023.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/14/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Polypharmacy is a common condition among older adults and is associated with adverse drug reactions and health outcomes, including falls, functional and cognitive impairment, and frailty. METHODS A prospective observational study will be conducted on older adults with polypharmacy. The aim is to assess the impact of a specialized outpatient clinic focused on pharmacotherapy optimization recently integrated into daily clinical practice in a Spanish public tertiary teaching hospital on patients' functional and cognitive abilities. Patients who attend a first consultation and meet inclusion criteria (≥75 years old, have a life expectancy≥3 months, and polypharmacy (≥5 prescribed medications) will be invited to participate in the study, until reach a calculated sample size of 104 participants. Patients will be excluded if they are enrolled in a clinical trial related to medication or in the event of a no-show or cancellation of the appointment at the first visit. Participants will receive usual care: a first consultation including multidisciplinary pharmacological optimization in the context of a CGA and subsequent face-to-face and/or telephone follow-up (∼3 and ∼6 months). The primary endpoint will be the functional (Barthel index) and cognitive change in capacities (IPCR - Índice de Incapacidad psíquica de la Cruz Roja). Secondary endpoints include medication changes, changes in patients' quality of life, rate of falling, and use of healthcare resources. DISCUSSION We expect that the close collaboration between professionals from different disciplines working together will be an effective strategy to improve the functional and cognitive abilities of older adults. TRIAL REGISTRATION ClinicalTrials.gov: NCT05408598 (March 1, 2022).
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Affiliation(s)
- Victoria Roncal-Belzunce
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain.
| | - Bernardo Abel Cedeño-Veloz
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Department of Geriatrics, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | | | - Marta Gutiérrez-Valencia
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | | | - Itxaso Marín-Epelde
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Department of Geriatrics, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - Iciar Echeverria-Beistegui
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain
| | | | - Arkaitz Galbete
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain
| | | | - Nicolás Martínez-Velilla
- Geriatric Unit, Navarrabiomed, Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Navarra, Spain; Department of Geriatrics, Hospital Universitario de Navarra (HUN), Pamplona, Spain
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Sánchez-Sánchez JL, Udina C, Medina-Rincón A, Esbrí-Victor M, Bartolomé-Martín I, Moral-Cuesta D, Marín-Epelde I, Ramon-Espinoza F, Sánchez-Latorre M, Idoate F, Goñi-Sarriés A, Martínez-Martínez B, Bonet RE, Librero J, Casas-Herrero Á. Correction: Effect of a multicomponent exercise program and cognitive stimulation (VIVIFRAIL-COGN) on falls in frail community older persons with high risk of falls: study protocol for a randomized multicenter control trial. BMC Geriatr 2023; 23:31. [PMID: 36658558 PMCID: PMC9854155 DOI: 10.1186/s12877-022-03535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Juan Luis Sánchez-Sánchez
- grid.7759.c0000000103580096MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain ,grid.410476.00000 0001 2174 6440Health Sciences Department, Universidad Pública de Navarra (UPNA), Pamplona, Spain ,grid.411175.70000 0001 1457 2980Institut de Viellissement, CHU Toulouse, Gerontopole de Toulouse, Toulouse, France
| | - Cristina Udina
- grid.510965.eParc Sanitari Pere Virgili, Barcelona, Spain ,grid.430994.30000 0004 1763 0287RE-FiT Bcn Research Group, Vall Hebron Research Institute, Barcelona, Spain
| | - Almudena Medina-Rincón
- grid.510965.eParc Sanitari Pere Virgili, Barcelona, Spain ,grid.430994.30000 0004 1763 0287RE-FiT Bcn Research Group, Vall Hebron Research Institute, Barcelona, Spain
| | - Mariano Esbrí-Victor
- grid.411094.90000 0004 0506 8127Geriatrics Department, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain
| | - Irene Bartolomé-Martín
- grid.411098.50000 0004 1767 639XGeriatrics Department, Hospital Universitario de Guadalajara (HUG), Guadalajara, Spain
| | - Débora Moral-Cuesta
- grid.411730.00000 0001 2191 685XGeriatrics Department, Hospital Universitario de Navarra (HUN), C/Irunlarrea s/n 31008, Pamplona, Spain
| | - Itxaso Marín-Epelde
- grid.411730.00000 0001 2191 685XGeriatrics Department, Hospital Universitario de Navarra (HUN), C/Irunlarrea s/n 31008, Pamplona, Spain
| | | | - Marina Sánchez-Latorre
- grid.411730.00000 0001 2191 685XGeriatrics Department, Hospital Universitario de Navarra (HUN), C/Irunlarrea s/n 31008, Pamplona, Spain
| | | | | | | | | | - Julián Librero
- grid.410476.00000 0001 2174 6440Health Sciences Department, Universidad Pública de Navarra (UPNA), Pamplona, Spain ,grid.508840.10000 0004 7662 6114Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Álvaro Casas-Herrero
- grid.410476.00000 0001 2174 6440Health Sciences Department, Universidad Pública de Navarra (UPNA), Pamplona, Spain ,grid.411730.00000 0001 2191 685XGeriatrics Department, Hospital Universitario de Navarra (HUN), C/Irunlarrea s/n 31008, Pamplona, Spain ,grid.508840.10000 0004 7662 6114Navarra Institute for Health Research (IdiSNA), Pamplona, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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Sánchez-Sánchez JL, de Souto Barreto P, Antón-Rodrigo I, Ramón-Espinoza F, Marín-Epelde I, Sánchez-Latorre M, Moral-Cuesta D, Casas-Herrero Á. Effects of a 12-week Vivifrail exercise program on intrinsic capacity among frail cognitively impaired community-dwelling older adults: secondary analysis of a multicentre randomised clinical trial. Age Ageing 2022; 51:6964933. [PMID: 36580558 PMCID: PMC9799251 DOI: 10.1093/ageing/afac303] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The World Health Organisation recently defined the construct of intrinsic capacity (IC), a function-based marker of older adult's health encompassing all mental and physical capacities of the individual. Multicomponent physical exercise (MCE) is a potential intervention capable to maintain/increase IC at older age; however, evidence is scarce on the effects of MCE on IC in cognitively impaired pre-frail/frail older adults. METHODS Secondary analyses of a randomised clinical trial. One hundred and eighty-eight older outpatients (age = 84.06 ± 4.77, 70.2% women) presenting with pre-frailty/frailty (according to Fried Criteria) and mild cognitive impairment (MCI)/mild dementia were recruited in the Geriatric clinics of three tertiary hospitals in Spain. Subjects were randomised to participate in the 12-week home-based individualised Vivifrail MCE or usual care. An IC index was created based on the z-score of the locomotion (Short Physical Performance Battery), cognitive (Montreal Cognitive Assessment), psychology (15-item Geriatric Depression Scale Yesavage) and vitality (handgrip strength) domains. RESULTS After the 3-month intervention, linear mixed models showed significant between-group differences in the evolution of the IC composite score (β=0.48; 95% confidence interval [CI] = 0.24, 0.74; P < 0.001), IC Locomotion (β = 0.42; 95% CI = 0.10, 0.74; P < 0.001), IC Cognition (β = 0.45; 95% CI = 0.03, 0.87; P < 0.05) and IC Vitality domains (β = 0.50; 95% CI = 0.25, 0.74 at 3-month) favouring the MCE group. CONCLUSIONS The 12-week Vivifrail multicomponent exercise program is an effective strategy to enhance IC, especially in terms of locomotion, cognition and vitality IC domains in community-dwelling older adults with pre-frailty/frailty and MCI/mild dementia, compared to usual care.
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Affiliation(s)
- Juan Luis Sánchez-Sánchez
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France,MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cadiz, Spain,Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France,CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France
| | - Iván Antón-Rodrigo
- Hospital of Eibar, OSI Debabarrena, Osakidetza, Eibar, Gipuzkoa, Spain,Grupo de Investigación en Atención Primaria, Biodonostia Institute of Health Research, San Sebastián, Gipuzkoa, Spain
| | | | - Itxaso Marín-Epelde
- Geriatric Department, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | | | - Débora Moral-Cuesta
- Geriatric Department, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - Álvaro Casas-Herrero
- Address correspondence to: Álvaro Casas-Herrero, Geriatrics Department, Hospital Universitario de Navarra (HUN), C/Irunlarrea s/n 31008, Pamplona, Spain.
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Chenhuichen C, Sánchez-Latorre M, Hernández-Amador ÁZ, Garaioa-Aramburu KJ, de Asteasu MLS, Martínez-Velilla N. Cambios en perfil clínico de pacientes hospitalizados en una unidad geriátrica de agudos tras la pandemia COVID-19. Rev Esp Geriatr Gerontol 2022; 57:195-196. [PMID: 35570066 PMCID: PMC9023322 DOI: 10.1016/j.regg.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/23/2022] [Accepted: 03/16/2022] [Indexed: 11/24/2022]
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Marín-Epelde I, Capón-Sáez A, Sánchez-Latorre M, Martínez-Velilla N. Atypical presentation of Tako-tsubo Syndrome in an 89-year-old patient: A case report. Rev Esp Geriatr Gerontol 2021; 56:378-379. [PMID: 34154836 DOI: 10.1016/j.regg.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/16/2021] [Accepted: 05/14/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Itxaso Marín-Epelde
- Department of Geriatric Medicine, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain; Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
| | - Amaya Capón-Sáez
- Department of Geriatric Medicine, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain; Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Marina Sánchez-Latorre
- Department of Geriatric Medicine, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Nicolás Martínez-Velilla
- Department of Geriatric Medicine, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain; Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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Chenhuichen C, Sánchez-Latorre M, Zubiría JM, Martínez-Velilla N. [Debut of type1 diabetes mellitus in a 91-year-old man]. Rev Esp Geriatr Gerontol 2021; 56:111-112. [PMID: 33494931 DOI: 10.1016/j.regg.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Chenhui Chenhuichen
- Servicio de Geriatría, Complejo Hospitalario de Navarra (CHN), Pamplona, España.
| | | | - Juan Manuel Zubiría
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra (CHN), Pamplona, España
| | - Nicolás Martínez-Velilla
- Servicio de Geriatría, Complejo Hospitalario de Navarra (CHN), Pamplona, España; Navarrabiomed, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud CarlosIII, Madrid, España
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