Aplicación de la evaluación geriátrica integral en los problemas sociales de adultos mayores

Abstract

Con los avances en la medicina cada vez más personas se incorporan a un segmento social creciente denominado “del adulto mayor”, por ello la salud del adulto mayor constituye un tema de estudio de suma importancia social. Con el objetivo de determinar los problemas sociales y las características geriátricas asociadas en adultos mayores, se realizó un estudio descriptivo transversal, en el que se entrevistó a 154 personas mayores de 60 años que acudieron a una campaña de salud y control metabólico en septiembre del 2005 en el Hospital Nacional Guillermo Almenara Irigoyen, organizada por el Servicio de Geriatría. Se encontró criterios diagnósticos de síndrome de caídas en 48,1% del total; incontinencia de orina de cualquier causa en 40,3%; dismovilidad de cualquier grado en 6,5%, y deterioro cognitivo leve a mayor en 63,6%. Cumplieron al menos un criterio de fragilidad y se catalogó como frágil a 74 personas. Mediante el test de Gijón modificado por la Universidad Cayetano Heredia, se determinó que 49,4% de los entrevistados tenía riesgo y/o problema social, identificando a 12 personas con diagnóstico de problema social. El 11,7% vive con el cónyuge de similar edad, y el 8,7% vive solo o los hijos están alejados. El 50,7% tiene solo una pensión mínima contributoria o carece de pensión; mientras que el 9,1% tiene una vivienda húmeda, incompleta o inadecuada. El 29,9% tiene relación solo con la familia y no sale del domicilio, mientras que el 28,6% requiere cuidados residenciales o cuidados permanentes. En conclusión, la evaluación geriátrica integral es importante en el estudio completo del anciano a todo nivel de atención.

Introduction: With recent avances in medical care available there is an increasing number of persons included in the so called ‘advanced age group’ or ‘elderly’. For this reason, the health of the elderly is now a very important topic to be studied from a social point of view. Objective: To determine social problems prevalent in the elderly. Material and Methods: A descriptive cross-sectional study was performed by interviewing 154 persons more than 60 years old who came to a health and metabolic control campaign organized by the Geriatrics Service in September 2005 in Guillarmo Almenara-Irigoyen National Hospital. Results: The average age of participants was 72.1 ± 8 years (range: 60 to 91 years), and 59.7 (92) were female. Diagnosis criteria for ‘ease of falling syndrome’ were found in 48.1% of participants, urinary incontinence of any cause in 40.3%, dismotility in 6.5%, and mild to major cognitive impairment in 63.6%. Seventy-four (48.1%) persons had at least one major criterion for defining frailty and were classified as being frail. Using the Gijon test modified by Cayetano Heredia University, we found that 49.4% of interviewed persons had social risks and/or problems, and 12 persons (7.8%) were identified as having social problems. Nearly one of nine (11.5%) of interviewees live with a similarly aged spouse, and 8.7% live on their own, or their children have moved away form the parental home. Half of the participants (50.7%) receive a minimal monthly allowance (from retirement public funds) or do not receive any income, 9.1% have their house in poor conditions (humid environment, incomplete building, or inadequately built). With respect to social networks, 29.9% have established relationthips only with their relatives, and do not get out of their home, while 28.6% require in-house care or permanent care. Conclusions: This integrated geriatric assessment is an important parto of any complete study performed in elderly people at any healthcare level.