Dra. Troncoso-Pantoja, Claudia

Objetivo principal: Interpretar el significado que se le asigna a las estrategias de enseñanza-aprendizaje en el área de salud destinada a personas mayores. Método: Estudio cualitativo de carácter exploratorio. Participaron personas mayores de 60 años y profesionales del área gerontológica con experiencia en la planificación y ejecución de educación en salud. La información fue recolectada a través de entrevista semiestructurada, y los datos fueron analizados a través de análisis de contenido. Resultados principales: Las personas mayores reconocen el realizar talleres y la educación individual como las mejores estrategias para recibir educación. Al triangular la información, los profesionales gerontológicos coinciden con la apreciación positiva de los talleres, pero acompañados de un adecuado diagnóstico participativo y desde la experiencia del participante. Conclusión principal: Los talleres se reconocen como la mejor estrategia de enseñanza-aprendizaje para personas mayores. Esta debe aplicarse considerando un diagnóstico participativo, con la experiencia de la persona mayor y ser mantenido en el tiempo.

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Adiposity and education are two independent risk factors for type 2 diabetes (T2D). However, there is limited evidence whether both education and adiposity are associated with T2D in an additive manner in the Chilean population. Aim: To investigate the joint association between adiposity and education with T2D in the Chilean adult population. Material and Methods: Analysis of data of the Chilean National Health Survey 2016-2017, which included 5,033 participants with a mean age of 43 years, (51% women). Poisson regression analyses with robust standard error were used to investigate the joint association of the education level and general and central adiposity with T2D. The results were reported as Prevalence Ratio and their 95% confidence intervals (PR, 95% CI). Results: Obesity was associated with a higher probability of having T2D in men than in women, however central adiposity was associated with a higher probability of having T2D in women than in men. Compared with men who had higher education (> 12 years) and had normal body weight, those with the same educational level and who were obese had 2.3-times higher probability of having T2D (PR: 2.35 [95% CI: 1.02; 5.39]). For women, having a low education and being obese was associated with 4.4-times higher probability of having T2D compared to those with higher education and normal body mass index (BMI) (PR: 4.47 [95% IC: 2.12; 9.24]). Similar results were observed when waist circumference was used as a marker of obesity rather than BMI. Conclusions: Women and men with higher BMI and low education had a higher risk of T2D. However, this risk was higher in women than in men.

Las caídas limitan las actividades de la vida diaria. Actualmente se desconoce cómo los niveles de actividad física (AF) varían luego de sufrir una caída. Objetivo: investigar los niveles de práctica de actividad física de personas mayores que han reportado caídas en los últimos 12 meses. Métodos: Se incluyeron 1.254 participantes ≥ 60 años de Encuesta Nacional de Salud (ENS) 2009-2010. La prevalencia de caídas en los últimos 12 meses se determinó mediante auto reporte. Los niveles de AF y el tiempo sedente se determinaron a través del cuestionario Global Physical Activity Questionnaire (GPAQ). La asociación entre caídas y AF fue investigada mediante regresión lineal. Resultados: El 70,5% [95% IC: 68,0; 72,8] de las personas mayores no reportaron caídas, mientras que un 19,4% [95% IC: 17,4; 21,5] reportó haber sufrido entre 1-2 caídas y un 10% [95% IC: 8,4; 11,8] ≥3 caídas en los últimos 12 meses. En comparación al grupo que reportó no sufrir caídas, aquellos que sufrieron ≥3 caídas realizaban 79,2 minutos menos de AF total/día. Resultados similares fueron observados para AF de transporte y AF moderada. No se encontraron diferencias para tiempo sedente o AF vigorosa. Conclusión: Personas mayores que sufrieron caídas en los últimos 12 meses reportaron realizar menos actividad física que sus contrapartes que no experimentaron caídas. A mediano y largo plazo, estos cambios en la actividad física podrían contribuir a resultados de salud adversos en una población.

Background: Walking pace is a well-known indicator of physical capability, but it is also a strong predictor of type 2 diabetes (T2D). However, there is a lack of evidence on the association between walking pace and T2D, specifically, within developing countries such as Chile. Aim: To investigate the association between self-reported walking pace and T2D in the Chilean adult population. Methods: 5520 Chilean participants (aged 15 to 90 years, 52.1% women) from the Chilean National Health Survey 2016–2017 were included in this cross-sectional study. Both walking pace (slow, average, and brisk) and diabetes data were collected through self-reported methods. Fasting blood glucose (reported in mg/dl) and glycosylated haemoglobin A (HbA1c) scores were determined via blood exams. Results: In the unadjusted model, and compared to people who reported a slow walking pace, those with average and brisk walking pace had lower blood glucose levels (β = −7.74 mg/dL (95% CI: −11.08 to −4.40) and β = −11.05 mg/dL (95% CI: −14.36 to −7.75), respectively) and lower HbA1c (β = −0.34% (95% CI: −0.57 to −0.11) and β= −0.72% (95% CI: −0.94 to −0.49)), respectively. After adjusting for sociodemographic, Body Mass Index and lifestyle factors, the association between glycaemia and HbA1c remained only for brisk walkers. Both the average and brisk walker categories had lower odds of T2D (OR: 0.59 (95% CI: 0.41 to 0.84) and (OR 0.48 (95% CI: 0.30 to 0.79), respectively). Conclusion: Brisk walkers were associated with lower blood glucose and HbA1c levels. Moreover, average to brisk walking pace also showed a lower risk for T2D.

Background: Handgrip strength is an indicator of frailty in older people. Aim: To determine the prevalence of low handgrip strength in older Chilean adults. Material and Methods: A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. Results: Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. Conclusions: The prevalence of low grip strength increased substantially with age.

Background: Walking speed is a strong predictor of non-communicable diseases and mortality. Aim: To investigate the association of self-reported walking pace with adiposity, metabolic and cardiovascular markers in the Chilean population. Material and Methods: Analysis of data from 5,077 participants of the 2009-2010 National Health Survey (ENS 2009-2010). Walking speed was self-reported as average or slow pace. Body mass index (BMI), waist circumference (WC), blood pressure, blood glucose, glycosylated hemoglobin and lipid profile were the outcome. Results: In Chile, 11% (95% confidence intervals [CI]: 10.0; 12.7) of the population reported a slow walking pace. Compared with average walking people, those reporting a slow pace had a higher body weight (difference (∆) 5.65 kg [95% CI: 3.22; 8.09], p < 0.01), BMI (D 2.48 kg/m 2 [95% CI: 1.53; 3.44], p < 0.01), WC (D 6.23 cm [95% CI: 4.12; 8.34], p < 0.01), serum triglycerides (D 30,9 mg/dl [95% CI: 5,31; 57,5], p = 0.018), and lower HDL cholesterol (D -2.32 mg/dl [95% CI: -4,24; -0,34], p = 0.022). Those reporting a slow pace had also a higher odd of being obese (odds ratio (OR): 2.46 [95% CI: 1.82; 3.33], p < 0.01), being diabetic (OR: 1.54 [95% CI: 1.02; 2.40], p = 0.018) and having metabolic syndrome (OR: 2.03 [95% CI: 1.30; 3.18], p = 0.002). Conclusions: In Chilean adults, slow walking pace is associated with and unfavorable adiposity and lipid profile, including a higher probability of being obese, diabetic and having metabolic syndrome.

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.

Fundamentos: La recopilación de los saberes y sabores de comidas tradicionales faculta la mantención de la identidad en las comunidades y los núcleos familiares, permitiendo ser un aporte para la alimentación saludable. Objetivo: Comprender el significado que representan las comidas tradicionales para un grupo de mujeres adultas mayores de la provincia de Concepción, Chile. Métodos: El estudio utilizó el paradigma cualitativo con enfoque fenomenológico interpretativo de Heidegger. Como estrategia de recolección de datos, se utilizó la entrevista semiestructurada. Las respuestas, se codificaron, reagruparon y analizaron a través de la técnica de análisis de contenido. Resultados: Las entrevistadas identifican recetas culinarias con características que son tradicionales para ellas, reconociendo ingredientes y formas de preparación que se han mantenido en el tiempo. Las materias primas utilizadas son las mismas que recuerdan desde su época de infancia, aunque se menciona una dificultad en la adquisición de estos productos, debido al acceso o el costo económico de su adquisición. Sin embrago, el cambio de ingredientes no es apreciado como una modificación mayor a la receta más clásica. Otro aspecto importante es la modificación de los sabores en las preparaciones. A lo anterior, los alimentos y preparaciones de antaño eran identificados como más naturales y por lo mismo, reconocidos como más saludable. Conclusiones: Las comidas tradicionales permiten entrecruzar simbolismos y significados en mujeres adultas mayores, que favorecen la valoración de la alimentación desde los sabores, formas de preparar e ingredientes utilizados, percibiéndose como una alternativa para la alimentación saludable.

Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.