Abstract
Objetivos
Evaluar el grado de respuesta a un cuestionario multidimensional autoadministrado en pacientes de 75 años de edad o mayores adscritos a un centro de salud de atención primaria y establecer las prevalencias de problemas sociales, cognitivos y con las actividades básicas e instrumentales de la vida diaria, morbilidad, polifarmacia, actividad física y caídas.
Diseño
Estudio descriptivo, transversal, basado en cuestionario autoadministrado enviado por correo postal.
Emplazamiento
Un centro de atención primaria de Barcelona.
Participantes
Un total de 1.299 ancianos de 75 años de edad o mayores.
Mediciones principales
Entorno social, actividades de la vida diaria, problemas sensoriales, morbilidad, síntomas físicos, entre ellos, incontinencia de esfínteres, estado cognitivo y uso de medicación.
Resultados
La tasa de respuesta fue del 68%. La edad promedio (± desviación estándar) de las mujeres que participaron fue significativamente mayor que la de los varones (82,5 ± 5,3 frente a 81,6 ± 5,0 años, respectivamente). Una proporción significativamente mayor de mujeres que de varones vivían solas (el 38,2 frente al 10,9%), tenían dificultades para mantener su casa acogedora (el 15,6 frente al 8,8%) y llegar a final de mes con suficientes recursos monetarios (el 18,0 frente al 13,6%). Globalmente, hubo una mayor proporción de mujeres que de varones que presentaban problemas médicos, problemas cognitivos, depresión y dificultades para llevar a cabo actividades de la vida diaria. Los sujetos que tenían dificultades para llegar a final de mes con suficientes recursos monetarios también presentaron globalmente mayores prevalencias de problemas en todas las dimensiones de esta evaluación. Los sujetos que vivían solos tenían una prevalencia menor de problemas en todas las dimensiones, pero una prevalencia mayor de depresión.
Conclusión
La evaluación multidimensional en ancianos por correo postal es un procedimiento eficaz que permite identificar múltiples problemas sociales y sanitarios. Además, es factible identificar a los más frágiles, para posteriormente realizar intervenciones preventivas y curativas, así como su seguimiento.
Palabras clave: Valoración geriátrica global, Ancianos, Atención primaria, Método postal, Efectividad
Abstract
Objective
To assess the response rate to a multidimensional, self administered questionnaire in patients ≥75 years old attending a primary health care center and to establish the prevalences of problems in the following dimensions: socioeconomical, cognitive, morbidity, polypharmacy, physical activity, falls, and activities of the daily living.
Design
Cross-sectional descriptive study based on a self-administered questionnaire posted by mail.
Setting
A primary health care center in Barcelona. Spain.
Participants
A total of 1299 patients ≥75 years old.
Main measurements Social surroundings, activities of the daily living, sensorial problems, morbidity, physical symptoms including sphincter's incontinence, cognitive status, and medication use.
Results
The response rate was 68% (95% CI, 0.65-0.70). The average age of the women who participated was significantly greater than the one of the men (82.5±5.3 vs 81.6±5.0, respectively). A significantly greater proportion of women than of men lived single (38.2 vs 10.9%); they had difficulties to maintain its house cosy (15.6 vs 8.8%) and they had difficulties to make ends meet (18.0 vs 13.6%). Globally, there were a greater proportion of women than of men whom they had: medical problems, cognitive problems, depression, and difficulties to carry out activities of the daily living. Overall, subjects that have had difficulties to make ends meet had greater prevalences of problems in all the dimensions of this evaluation. On the other hand, subjects that lived single had lower prevalences of problems in all the dimensions except they had a greater prevalence of depression.
Conclusion
The multidimensional evaluation in elderly patients by the postal method is an efficient procedure that allows identifying many socioeconomic and health problems. In addition, it is feasible to identify to most fragile subjects and latter on to carry out preventive and curative interventions on them as well as to make their follow up.
Key words: Comprehensive geriatric evaluation, Elderly patient, Primary care, Postal method, Effectiveness
Footnotes
Fuente de financiación: Fundació Agrupació Mútua (premio Ámbito de la Vejez).
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