Dra. Troncoso-Pantoja, Claudia

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.

Introduction: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. Material and Method: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. Results: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. Conclusion: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

Background: The Frailty Index (FI) is used to quantify and summarize vulnerability status in people. In Chile, no development and assessment of a FI have been explored. Objective: To develop and evaluate a FI using representative data from Chilean adults aged 40 years and older stratified by sex. Design: Cross-sectional study. Setting: National representative data from the Chilean National Health Survey 2016–2017 (CNHS 2016–2017). Participants: 3,036 participants older than 40 years with complete data for all variables. Measurements: A 49-item FI was developed and evaluated. This FI included deficits from comorbidities, functional limitations, mental health status, physical activity, anthropometry, medications, and falls. A score between 0 and 1 was calculated for each person. Descriptive statistics and linear regression models were employed to evaluate the FI’s performance in the population. Comparative analyses were carried out to evaluate the FI score by age (<60 and ≥ 60 years). Results: The mean FI score was 0.15 (SD:0.09), with a 99% upper limit of 0.46. Scores were greater in women than men (0.17 [SD:0.09]) vs. 0.12 [0.08]); in people older than 80 years (0.22 [0.11]), and in people with ≤8 years of education (0.18 [0.10]) compared with those with >12 years (0.12 [0.08]). The average age-related increase in the FI was 2.3%. When a cut-off point ≥ 0.25 was applied, the prevalence of frail individuals was 11.8% (95% CI: 10.0 to 13.8) in the general population. The prevalence was higher in women 15.9% [95% CI: 13.3 to 18.9] than men 7.4% [95% CI: 5.3 to 10.1]. In a comparative analysis by age, higher FI mean scores and prevalence of frail were observed in people ≥ 60 than younger than 60. Conclusions: The mean FI score and frailty prevalence were higher in women than men, in people with fewer years of formal education, and incremented markedly with age. This FI can be used for early detection of frailty status focusing on women and middle-aged people as a strategy to delay or prevent frailty-related consequences.