Dra. Troncoso-Pantoja, Claudia

El envejecimiento será una de las transformaciones sociales más importantes del siglo XXI en todo el mundo. En los últimos 40 años, Chile ha triplicado su población adulta mayor. Como resultado, para el 2050 el país tendrá la mayor proporción de adultos mayores en América Latina. Este notable crecimiento refuerza la necesidad de identificar su situación actual y revisar qué está haciendo la sociedad para mantener a las personas mayores como miembros activos. En este contexto, esta revisión narrativa tuvo como objetivo describir el perfil sociodemográfico, epidemiológico y sociocultural de los adultos mayores chilenos. Además, se identificaron programas y políticas públicas enfocadas a la mejora de su calidad de vida.

Depressive disorders are recognized as one of the most common mental health conditions across different age groups. However, the risk factors associated with depression among older people from low-and middle-income countries remains unclear. This study aims to identify socio-demographic, health and psychosocial-related factors associated with depression in Chilean older adults. A cross-sectional study was carried out in a representative sample of 1,765 adults aged ≥60 years participants from the Chilean National Health Survey 2016–2017. Depression was assessed with the Composite International Diagnostic Interview (CIDI-SF). Associations between the exposure variables and depression were investigated using Poisson regression analyses. The main findings indicated that women showed higher likelihood of depression than men (Prevalence Ratio (PR) = 2.6 [95% CI: 1.40; 4.89]). An increased likelihood of depression was found in older adults with chronic pain, multimorbidity (≥2 diseases), previous diagnose of depression, high perception of stress, financial stress, and difficulties for social participation. In women, higher likelihood of depression was found for those with the frailty phenotype (PR:8.53 [95% CI: 1.68; 43.32]), rheumatoid arthritis (PR:2.41 [95% CI: 1.34; 4.34]), insomnia (PR:2.99 [95% CI: 1.74; 5.12]) and low self-rated well-being (PR:4.94 [95% CI: 2.26; 10.79]). Men who were divorced (PR:7.10 [95% CI: 1.44; 34.90]) or widowed (PR:10.83 [95% CI: 3.71; 31.58]), obese (PR:5.08 [95% CI: 1.48; 17.42) and who had asthma (PR: 7.60 [95% CI: 2.31; 24.99]) were associated with higher odds of depression. The current findings may have clinical implications for the early identification of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.

Background: One of the side effects of cancer treatment is a low level of physical activity (PA) due to fatigue and pain. Aim: To quantify PA levels in Chilean people with cancer. Material and Methods: Analysis of the National Health Survey 2016-2017 including 6,233 participants, comparing those with and without a self-report of cancer was conducted. Levels of PA and sitting time were assessed using the Global Physical Activity Questionnaire. Results: 3% of participants [confidence intervals (CI): 2.6; 3.9] reported having cancer and 34% [95% CI: 22.7; 46.7] of these reported being physically inactive, compared to 25% [95% CI: 22.5; 27,3] of those without cancer. Participants with cancer performed 56 and 77 minutes/day lower vigorous and total PA than participants without cancer. No differences between groups were observed for commuting PA, moderate PA and sedentary time. Lower level of PA was independent of the years elapsed since the diagnosis of cancer. Conclusions: People with cancer are less physically active than their counterparts without the disease.

Objective: The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. Methods: The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure -90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose -7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. Results: Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. Conclusion: WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.

Cumplir las recomendaciones incluidas en las Guías Alimentarias permite un acercamiento hacia un estilo de vida saludable. El objetivo de este estudio fue caracterizar los estilos de vida de la población chilena y su asociación al cumplimiento de 5 recomendaciones de las Guías Alimentarias Basadas en Alimentos (GABA) chilenas. Se utilizaron datos de la Encuesta Nacional de Salud 2016-2017. Los participantes fueron divididos en 4 grupos: aquellos que no cumplieron con ninguna recomendación, los que cumplían una, los que cumplían con 2 y los que cumplían con 3 o más recomendaciones saludables, estableciendo a este último como grupo de referencia. El 43,3% de la muestra no cumplió ninguna de las recomendaciones incorporados en esta investigación. De los que cumplían a lo menos 3, el 35,9% presentó un estado nutricional normal, el 38,9% reportó nunca haber fumado y el 82% se auto percibía como saludable. Además, los que cumplían las recomendaciones, presentaron niveles más altos de actividad física. Personas que incorporan y aplican las recomendaciones de las GABA, tienden a presentar conductas de vida más saludable. Estrategias comunicacionales efectivas y formativas en educación alimentaria sobre estas recomendaciones son claves para prevenir el acelerado y temprano crecimiento de las patologías crónicas.

Chile es uno de los países de Latinoamérica que exhibe un mayor envejecimiento poblacional, por lo que es necesario visualizar distintas herramientas que direccionen estilos de vida saludables en esta etapa de la trayectoria vital. Las Guías Alimentarias Basadas en Alimentos (GABA) entregan recomendaciones que permiten mejorar la calidad de vida de personas mayores. Por lo anterior, el objetivo del estudio fue determinar el nivel de cumplimiento de recomendaciones de las GABA y su asociación con variables antropométricas, metabólicas y de estilos de vida en 1.789 personas mayores de 60 años que participaron en la Encuesta Nacional de Salud 2016-2017. Se realizó un estudio descriptivo de corte transversal, en donde los participantes se subdividieron en cuatro grupos según cumplimiento de las GABA: no cumple, cumple con 1, 2 o a lo menos 3 recomendaciones de consumo de legumbres, frutas y verduras, lácteos, agua y pescado. Como resultado, el 43,8% de las personas mayores que participaron no cumplieron ninguna de las recomendaciones GABA evaluadas; estos últimos, realizaban menos actividad física y presentaban, además, una mayor probabilidad de pasar más tiempo sentados (p-tendencia: <0,001). Como conclusión, se destaca que cerca del 50% de las personas mayores en Chile no adhieren a las recomendaciones de las GABA, lo que podría repercutir en implicaciones en la salud y bienestar de la población mayor.

Background: A low education level has been associated with cognitive impairment in older adults. Aim: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. Material and Methods: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. Results: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. Conclusions: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Background: Genetic variants within the FTO gene have been associated with increased adiposity and metabolic markers; however, there is limited evidence regarding the association of FTO gene variants with physical activity-related variables. The authors aimed to investigate the association of the rs17817449 single-nucleotide polymorphism of FTO with physical activity, sedentary time, and cardiorespiratory fitness in Chilean adults. Methods: A total of 409 participants from the GENADIO study were included and genotyped for the rs17817449 single-nucleotide polymorphism of FTO in this cross-sectional study. Physical activity and sedentary time were measured with ActiGraph accelerometers. Cardiorespiratory fitness was assessed using the Chester step test. The associations were assessed by using multivariate regression analyses. Results: No associations were found for FTO variant with physical activity levels and cardiorespiratory fitness. The risk allele (G) of the FTO was found to be associated with sedentary time in the minimally adjusted model (β = 19.7 min/d; 95% confidence interval, 4.0 to 35.5, per each copy of the risk allele; P = .006), but the association was no longer significant when body mass index was included as a confounder (P = .211). Conclusion: The rs17817449 single-nucleotide polymorphism of the FTO gene was not associated with the level of physical activity, cardiorespiratory fitness, and sedentary behaviors in Chilean adults.

El objetivo del trabajo fue analizar el posible efecto protector de la lactancia materna respecto a la obesidad infantil versus fórmulas lácteas. Se consultaron las bases de datos PubMed, Web of Science y Scielo, considerándose los artículos más actualizados sobre el tema. La evidencia analizada señala que los menores alimentados con lactancia materna exclusiva reportan bajos niveles de sobrepeso y obesidad, a diferencia de los alimentados con fórmulas lácteas infantiles. Se concluye que la lactancia materna exclusiva, hasta el sexto mes de vida del lactante, y complementada con alimentación solida (no láctea) hasta los dos o más años, es recomendada y podría proteger contra la obesidad infantil y sus comorbilidades asociadas en la vida adulta.

Background: The assessment of frailty among older people could help to reduce its social and health burden. Aim: To determine and characterize the prevalence of frailty in Chilean older adults. Material and Methods: We studied 233 participants, aged > 60 years, participating in the Chilean National Health Survey 2016-2017. Frailty was assessed using modified Fried criteria. Thus, people classified as frail should meet at least 3 out of the 5 criteria (low strength, low physical activity, low body mass index, slow walking pace and tiredness). Results: The prevalence of frailty was 10.9% (7.7% for men and 14.1% for women). The prevalence of pre-frailty was 59.0% whereas 30.1% of participants were classified as robust. At the age of 80 years 58 and 62% of men and women were frail, respectively. These figures increased to 90 and 87% at the age of 90 years. The prevalence of pre-frailty increased from 43 to 92.1% among men and from 76% and 78% among women from the ages of 60 to 90 years, respectively. Conclusions: The prevalence of frailty increased markedly with age. It is important to implement prevention strategies to allow an early identification of high-risk individuals.