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Age, Sep 4, 2015

Life span is a complex and multifactorial trait, which is shaped by genetic, epigenetic, environm... more Life span is a complex and multifactorial trait, which is shaped by genetic, epigenetic, environmental, and stochastic factors. The possibility that highly hypervariable short tandem repeats (STRs) associated with longevity has been largely explored by comparing the genotypic pools of long lived and younger individuals, but results so far have been contradictory. In view of these contradictory findings, the present study aims to investigate whether HUMTHO1 and HUMCSF1PO STRs, previously associated with longevity, exert a role as a modulator of life expectancy, as well as to assess the extent to which other autosomal STR markers are associated with human longevity in population from northern Spain. To that end, 21 autosomal microsatellite markers have been studied in 304 nonagenarian individuals (more than 90 years old) and 516 younger controls of European descent. Our results do not confirm the association found in previous studies between longevity and THO1 and CSF1PO loci. However, significant association between longevity and autosomal STR markers D12S391, D22S1045, and DS441 was observed. Even more, when we compared allelic frequency distribution of the 21 STR markers between cases and controls, we found that 6 out of the 21 STRs studied showed different allelic frequencies, thus suggesting that the genomic portrait of the human longevity is far complex and probably shaped by a high number of genomic loci.

Trans Roy Soc Trop Med Hyg, 2011

European Geriatric Medicine, Sep 1, 2014

Introduction: The aim of this study was to evaluate if the use of a structured scoring of support... more Introduction: The aim of this study was to evaluate if the use of a structured scoring of supporting nursing tasks in the evening and night, leads to earlier discharge home in geriatric rehabilitation patients. Methods: A pre-and post-implementation cohort design was followed. One cohort (n = 200) was assessed before and the other (n = 283) after the implementation of the scorecard. The implementation consisted of weekly filling out a validated structured scorecard for identifying the supporting nursing tasks, discussing them in the multidisciplinary team-meeting, in order to establish if discharge home was possible with help in less than 3 nursing tasks within 2 weeks. Results: Both cohorts were comparable in age, gender and reasons for admission (mean age 80 years (SD:10); 69% females). Reason for admission were stroke (23%), joint replacement (13%), traumatic injuries (32%), and other (32%). Participants from the post-implementation cohort were discharged home earlier, within 48 days (SD:26) compared with 56 days (SD:31) in the preimplementation cohort; P = 0.044. 28% of the participants that were able to be discharged home according to the supporting nursing tasks, were discharged within 2 weeks. Reasons for discharge delay were: no realized home adjustments (47%), diminished cognition participant (29%) and impaired general condition participant or informal caregiver (65%). Conclusion: The use of a scorecard for discharge planning may lead to earlier discharge home. After being indicated for discharge, this is often not realised within 2 weeks. An early inventarisation of the possibilities and barriers in the home situation is needed to avoid discharge delay.

Durante el año 1994, un equipo de trabajo de la Residencia Arana fue elaborando un plan de atenci... more Durante el año 1994, un equipo de trabajo de la Residencia Arana fue elaborando un plan de atención individualizada. Este nuevo plan, que se está instaurando progresivamente, se creó con la idea de servir como instrumento de trabajo interdisciplinar, siendo su objetivo proporcionar una atención integral y personalizada en función de las necesidades del residente. El plan incidía especialmente en el período de adaptación.

Maturitas, 2015

Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full ext... more Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full extent of its metabolic functions is not known in detail. One of the main roles assigned to albumin is as an indicator of malnutrition. There are many factors, in addition to nutrition, that influence levels of albumin in plasma. The main aim of this review is to assess the clinical significance of albumin in elderly people in the community, in hospital and in care homes. Following the review, it can be stated that age is not a cause of hypoalbuminemia. Albumin is a good marker of nutritional status in clinically stable people. Significant loss of muscle mass has been observed in elderly people with low albumin levels. Hypoalbuminemia is a mortality prognostic factor in elderly people, whether they live in the community or they are in hospital or institutionalized. Low levels of albumin are associated to worse recovery following acute pathologies. Inflammatory state and, particularly, high concentrations of IL-6 and TNF-alpha, are two of the main influencing factors of hypoalbuminemia. In elderly patients with a hip fracture, albumin levels below 38 g/L are associated to a higher risk of post-surgery complications, especially infections. Further research is needed on the impact of nutritional intervention upon albumin levels and on the outcomes in elderly people in the community, in hospital and in care.

Maturitas, 2016

Background: Frailty is a geriatric syndrome that predicts the onset of disability, morbidity and ... more Background: Frailty is a geriatric syndrome that predicts the onset of disability, morbidity and mortality in elderly people; it is a state of pre-disability and is reversible. The aim of this review is to assess how nutrition influences both the risk of developing frailty and its treatment. Data sources: We searched two databases, PubMed and Web of Science. We included epidemiologic studies and clinical trials carried out on people aged over 65 years. We included 32 studies with a total of over 50,000 participants. Results: The prevalence of frailty is ranges from 15% among elderly people living in the community to 54% among those hospitalized. Furthermore, the prevalence of frailty is disproportionately high among elderly people who are malnourished. Malnutrition, which is very prevalent in geriatric populations, is one of the main risk factors for the onset of frailty. A good nutritional status and, wherever necessary, supplementation with macronutrients and micronutrients reduce the risk of developing frailty. Physical exercise has been shown to improve functional status, helps to prevent frailty and is an effective treatment to reverse it. Despite the relatively large number of studies included, this review has some limitations. Firstly, variability in the design of the studies and their different aims reduce their comparability. Secondly, several of the studies did not adequately define frailty. Conclusions: Poor nutritional status is associated with the onset of frailty. Screening and early diagnosis of malnutrition and frailty in elderly people will help to prevent the onset of disability. Effective treatment is based on correction of the macro-and micronutrient deficit and physical exercise.

Revista Española de Geriatría y Gerontología, 2007

Con la edad se produce una alteración de la respuesta inmunitaria. Por otro lado, la malnutrición... more Con la edad se produce una alteración de la respuesta inmunitaria. Por otro lado, la malnutrición proteico-energética es la causa más común de inmunodepresión en el mundo. Las alteraciones nutricionales se observan en casi un tercio de los mayores de los países industrializados y en el medio residencial es un frecuente problema de salud. La infección genera, por un lado, un aumento de los requerimientos energéticos y, por otro, contribuye a generar una disminución del apetito. El presente trabajo hace una revisión de la estrecha relación existente entre malnutrición y disminución de la resistencia a las infecciones en la literatura científica, y analiza en particular algunas infecciones que pueden generar alarma en los centros residenciales, como son la tuberculosis y el sida.

Revista Española de Geriatría y Gerontología, 2011

Introducción: En la actualidad existen notables diferencias en el envejecimiento de los individuo... more Introducción: En la actualidad existen notables diferencias en el envejecimiento de los individuos de las poblaciones modernas. Mientras que algunos de ellos disfrutan de un prolongado envejecimiento saludable, otros desarrollan enfermedades neurodegenerativas como la enfermedad de Alzheimer (EA). Los factores ambientales son decisivos en este hecho, pero la genética puede contribuir a explicar las diferencias observadas. Recientemente se ha postulado que los genes de la longevidad podrían ser también neuroprotectores. Objetivos: Evaluar si determinadas variantes genéticas relacionadas con la longevidad pueden tener un carácter neuroprotector. Métodos: Los sujetos a estudio son las personas con una edad superior a 90 años. De cada participante se realizará la recogida de datos sociodemográficos, clínicos y múltiples valoraciones: cognitiva, funcional, antropométrica, nutricional, sensorial y física. Además, se realizará el análisis de 64 loci SNPs, distribuidos en 13 genes candidatos FOXO3, SIRT1, TOMM40, APOE, PICALM, COMT, CETP, CLU, CR1, IL-6, PCK-1, ZNF224 y ACE mediante Taqman array. Resultados: Obtener un mayor conocimiento sobre los alelos infra/sobre representados en las personas nonagenarias. Además, la comparación de las características genéticas de los nonagenarios con EA con aquellos libres de enfermedad permitirá observar vinculaciones entre determinados alelos con la protección o el riesgo de EA. La información asociada de los participantes permitirá crear subgrupos mostrando las interacciones entre el ambiente y las variaciones genéticas en relación al envejecimiento saludable y la EA. Conclusión: El estudio de la variabilidad genética de las personas nonagenarias nos puede dar información sobre los alelos relacionados con la longevidad y la neuroprotección.

Age, Sep 4, 2015

Life span is a complex and multifactorial trait, which is shaped by genetic, epigenetic, environm... more Life span is a complex and multifactorial trait, which is shaped by genetic, epigenetic, environmental, and stochastic factors. The possibility that highly hypervariable short tandem repeats (STRs) associated with longevity has been largely explored by comparing the genotypic pools of long lived and younger individuals, but results so far have been contradictory. In view of these contradictory findings, the present study aims to investigate whether HUMTHO1 and HUMCSF1PO STRs, previously associated with longevity, exert a role as a modulator of life expectancy, as well as to assess the extent to which other autosomal STR markers are associated with human longevity in population from northern Spain. To that end, 21 autosomal microsatellite markers have been studied in 304 nonagenarian individuals (more than 90 years old) and 516 younger controls of European descent. Our results do not confirm the association found in previous studies between longevity and THO1 and CSF1PO loci. However, significant association between longevity and autosomal STR markers D12S391, D22S1045, and DS441 was observed. Even more, when we compared allelic frequency distribution of the 21 STR markers between cases and controls, we found that 6 out of the 21 STRs studied showed different allelic frequencies, thus suggesting that the genomic portrait of the human longevity is far complex and probably shaped by a high number of genomic loci.

Trans Roy Soc Trop Med Hyg, 2011

European Geriatric Medicine, Sep 1, 2014

Introduction: The aim of this study was to evaluate if the use of a structured scoring of support... more Introduction: The aim of this study was to evaluate if the use of a structured scoring of supporting nursing tasks in the evening and night, leads to earlier discharge home in geriatric rehabilitation patients. Methods: A pre-and post-implementation cohort design was followed. One cohort (n = 200) was assessed before and the other (n = 283) after the implementation of the scorecard. The implementation consisted of weekly filling out a validated structured scorecard for identifying the supporting nursing tasks, discussing them in the multidisciplinary team-meeting, in order to establish if discharge home was possible with help in less than 3 nursing tasks within 2 weeks. Results: Both cohorts were comparable in age, gender and reasons for admission (mean age 80 years (SD:10); 69% females). Reason for admission were stroke (23%), joint replacement (13%), traumatic injuries (32%), and other (32%). Participants from the post-implementation cohort were discharged home earlier, within 48 days (SD:26) compared with 56 days (SD:31) in the preimplementation cohort; P = 0.044. 28% of the participants that were able to be discharged home according to the supporting nursing tasks, were discharged within 2 weeks. Reasons for discharge delay were: no realized home adjustments (47%), diminished cognition participant (29%) and impaired general condition participant or informal caregiver (65%). Conclusion: The use of a scorecard for discharge planning may lead to earlier discharge home. After being indicated for discharge, this is often not realised within 2 weeks. An early inventarisation of the possibilities and barriers in the home situation is needed to avoid discharge delay.

Durante el año 1994, un equipo de trabajo de la Residencia Arana fue elaborando un plan de atenci... more Durante el año 1994, un equipo de trabajo de la Residencia Arana fue elaborando un plan de atención individualizada. Este nuevo plan, que se está instaurando progresivamente, se creó con la idea de servir como instrumento de trabajo interdisciplinar, siendo su objetivo proporcionar una atención integral y personalizada en función de las necesidades del residente. El plan incidía especialmente en el período de adaptación.

Maturitas, 2015

Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full ext... more Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full extent of its metabolic functions is not known in detail. One of the main roles assigned to albumin is as an indicator of malnutrition. There are many factors, in addition to nutrition, that influence levels of albumin in plasma. The main aim of this review is to assess the clinical significance of albumin in elderly people in the community, in hospital and in care homes. Following the review, it can be stated that age is not a cause of hypoalbuminemia. Albumin is a good marker of nutritional status in clinically stable people. Significant loss of muscle mass has been observed in elderly people with low albumin levels. Hypoalbuminemia is a mortality prognostic factor in elderly people, whether they live in the community or they are in hospital or institutionalized. Low levels of albumin are associated to worse recovery following acute pathologies. Inflammatory state and, particularly, high concentrations of IL-6 and TNF-alpha, are two of the main influencing factors of hypoalbuminemia. In elderly patients with a hip fracture, albumin levels below 38 g/L are associated to a higher risk of post-surgery complications, especially infections. Further research is needed on the impact of nutritional intervention upon albumin levels and on the outcomes in elderly people in the community, in hospital and in care.

Maturitas, 2016

Background: Frailty is a geriatric syndrome that predicts the onset of disability, morbidity and ... more Background: Frailty is a geriatric syndrome that predicts the onset of disability, morbidity and mortality in elderly people; it is a state of pre-disability and is reversible. The aim of this review is to assess how nutrition influences both the risk of developing frailty and its treatment. Data sources: We searched two databases, PubMed and Web of Science. We included epidemiologic studies and clinical trials carried out on people aged over 65 years. We included 32 studies with a total of over 50,000 participants. Results: The prevalence of frailty is ranges from 15% among elderly people living in the community to 54% among those hospitalized. Furthermore, the prevalence of frailty is disproportionately high among elderly people who are malnourished. Malnutrition, which is very prevalent in geriatric populations, is one of the main risk factors for the onset of frailty. A good nutritional status and, wherever necessary, supplementation with macronutrients and micronutrients reduce the risk of developing frailty. Physical exercise has been shown to improve functional status, helps to prevent frailty and is an effective treatment to reverse it. Despite the relatively large number of studies included, this review has some limitations. Firstly, variability in the design of the studies and their different aims reduce their comparability. Secondly, several of the studies did not adequately define frailty. Conclusions: Poor nutritional status is associated with the onset of frailty. Screening and early diagnosis of malnutrition and frailty in elderly people will help to prevent the onset of disability. Effective treatment is based on correction of the macro-and micronutrient deficit and physical exercise.

Revista Española de Geriatría y Gerontología, 2007

Con la edad se produce una alteración de la respuesta inmunitaria. Por otro lado, la malnutrición... more Con la edad se produce una alteración de la respuesta inmunitaria. Por otro lado, la malnutrición proteico-energética es la causa más común de inmunodepresión en el mundo. Las alteraciones nutricionales se observan en casi un tercio de los mayores de los países industrializados y en el medio residencial es un frecuente problema de salud. La infección genera, por un lado, un aumento de los requerimientos energéticos y, por otro, contribuye a generar una disminución del apetito. El presente trabajo hace una revisión de la estrecha relación existente entre malnutrición y disminución de la resistencia a las infecciones en la literatura científica, y analiza en particular algunas infecciones que pueden generar alarma en los centros residenciales, como son la tuberculosis y el sida.

Revista Española de Geriatría y Gerontología, 2011

Introducción: En la actualidad existen notables diferencias en el envejecimiento de los individuo... more Introducción: En la actualidad existen notables diferencias en el envejecimiento de los individuos de las poblaciones modernas. Mientras que algunos de ellos disfrutan de un prolongado envejecimiento saludable, otros desarrollan enfermedades neurodegenerativas como la enfermedad de Alzheimer (EA). Los factores ambientales son decisivos en este hecho, pero la genética puede contribuir a explicar las diferencias observadas. Recientemente se ha postulado que los genes de la longevidad podrían ser también neuroprotectores. Objetivos: Evaluar si determinadas variantes genéticas relacionadas con la longevidad pueden tener un carácter neuroprotector. Métodos: Los sujetos a estudio son las personas con una edad superior a 90 años. De cada participante se realizará la recogida de datos sociodemográficos, clínicos y múltiples valoraciones: cognitiva, funcional, antropométrica, nutricional, sensorial y física. Además, se realizará el análisis de 64 loci SNPs, distribuidos en 13 genes candidatos FOXO3, SIRT1, TOMM40, APOE, PICALM, COMT, CETP, CLU, CR1, IL-6, PCK-1, ZNF224 y ACE mediante Taqman array. Resultados: Obtener un mayor conocimiento sobre los alelos infra/sobre representados en las personas nonagenarias. Además, la comparación de las características genéticas de los nonagenarios con EA con aquellos libres de enfermedad permitirá observar vinculaciones entre determinados alelos con la protección o el riesgo de EA. La información asociada de los participantes permitirá crear subgrupos mostrando las interacciones entre el ambiente y las variaciones genéticas en relación al envejecimiento saludable y la EA. Conclusión: El estudio de la variabilidad genética de las personas nonagenarias nos puede dar información sobre los alelos relacionados con la longevidad y la neuroprotección.