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Objective: To describe the experiences of older adults around forced displacement due to the Colombian armed conflict. Methods: Interpretive-comprehensive study, with a hermeneutical approach; several types of sampling were carried out. The participants were 12 people aged over 60 years, who reported having being displaced and who participated in the SABE Colombia Survey. The data were encoded using the Atlas.ti software. A process of condensation of central analytical, support and emerging categories was made. Results: The displacement generated by the armed conflict has been decisive in the current life conditions of the participants. They know that they are survivors of someone else's violence; there is dislocation, loss of territory, de-anchoring, lack of protection and insecurity. To the stigma of old age, it is added being displaced and being strangers in a place where they don’t belong. They live the violent uprooting of their lands and the confusion of their identity; they found themselves in a foreign scene where they were the unusual and the strangers; from receiving threats, they passed to be labeled as ‘threatening’. This forced displacement stems from violence, but also from fear, and it marks the trajectory of life for older people who experience a prolonged struggle for survival in often hostile environments, living "permanently" displaced. Conclusion: When there is displacement, older people are not only shed of their land and their home, but also from their cosmos and their vital referents; in addition, it changes their life trajectory and their place in the world. Interventions should be designed based on specific particular and contextual analyses. Resumen Objetivo: Describir las vivencias y experiencias de adultos mayores en torno al desplazamiento forzado por efectos del conflicto armado. Métodos: Estudio interpretativo-comprensivo, con un enfoque hermenéutico. Los participantes fueron 12 personas mayores de 60 años que reportaron haber sido desplazadas y que participaron en de la Encuesta SABE Colombia. Los datos se codificaron utilizando el software Atlas.ti. Se hizo un proceso de condensación de categorías analíticas centrales, de soporte y emergentes. Resultados: El desplazamiento generado por el conflicto armado ha sido decisivo en las actuales condiciones de vida de los participantes. Saben que son sobrevivientes de una violencia ajena, hay desubicación, desterritorializacion, desanclaje, desprotección, inseguridad. Al estigma de la vejez se le suma el ser desplazados y extraños en un lugar donde no tienen lugar. Viven el desarraigo violento de sus tierras, la confusión de su identidad, se encontraron en un escenario ajeno donde ellos eran los raros y los extraños, de recibir amenazas pasaron al señalamiento de ser amenazantes. Este desplazamiento forzado nace de la violencia, pero también del miedo y marca la trayectoria de vida a las personas mayores quienes experimentan una prolongada lucha por la supervivencia en entornos a menudo hostiles, viven desplazados "permanentemente". Conclusión: Cuando hay desplazamiento, las personas mayores no solo se despojan de su tierra, de su casa, sino de su cosmos, de sus referentes vitales y se modifica su trayectoria de vida y su lugar en el mundo. Las intervenciones deben ser diseñadas basadas en análisis particulares y contextuales específicos.

Background We determine the best combination of factors for predicting the risk of developing fear of falling (FOF) in older people via Classification Regression Tree (CaRT) analysis. Methods Community-dwelling older adults living in Canada, Albania, Brazil, and Colombia were from International Mobility in Aging Study (IMIAS). In 2014, 1,725 participants (aged 65–74) were assessed. With a retention rate of 81%, in 2016, 1,409 individuals were reassessed. Risk factors for FOF were entered into the CaRT: age, sex, education, self-rated health, comorbidity, medication, visual impairment, frailty, cognitive deficit, depression, fall history, Short Physical Performance Battery (SPPB), walking aid use, and mobility disability measured by the Nagi questionnaire. Results The classification tree included 12 end groups representing differential risks of FOF with a minimum of two and a maximum of five predictors. The first split in the tree involved impaired physical function (SPPB scores). Respondents with less than 8 in SPPB score and mobility disability had 82% risk of developing FOF at the end of 2-year follow-up. Between 23.2% and 82.3% of the risk of developing FOF in 2 years of follow-up were explained by only five variables: age, sex, self-rated health, functional impairment measured by SPPB, and mobility disability. In those with no functional impairment or mobility disability, levels of education, sex, and self-rated health were important predictors of FOF in the future. Conclusion This classification tree included different groups based on specific combinations of a maximum of five easily measurable predictors with emphasis on impaired physical functioning risk factors for developing FOF.

To identify the main factors associated with disability in older adults in Colombia, adjusted according to structural and intermediary determinants of healthy aging.This study used cross-sectional data from 23 694 adults over 60 years of age in the SABE Colombia nationwide survey. Structural determinants such as demographic and socioeconomic position variables were analyzed. Intermediary variables were classified into three blocks: intrinsic capacity, physical and built environment, and health care systems. Data analysis employed multivariate logistic regression.The prevalence of overall disability was 21% for activities of daily living, 38% for instrumental activities of daily living, and 33% for mobility disability. Disability was associated with sociodemographic structural determinants such as older age, female sex, rural residence, never married/divorced, living alone, low educational level, and Indigenous/Black ethnicity. With regard to determinants of socioeconomic position, net low income, poor socioeconomic stratum, insufficient income perception, and a subsidized health insurance scheme exerted a major influence on disability. Intermediary determinants of intrinsic capacity, such as poor self-rated health, multimorbidity, low grip strength, sedentary lifestyle, early childhood economic adversity, no social support, and no participation in activities, were significantly associated with disability.Actions that affect the main factors associated with disability, such as reducing health inequities through policies, strategies, and activities, can contribute significantly to the well-being and quality of life of Colombian older adults.Determinar los principales factores asociados con la discapacidad en personas mayores en Colombia, ajustados según determinantes estructurales e intermediarios del envejecimiento saludable.Este estudio empleó datos transversales de 23 694 adultos de más de 60 años provenientes de la encuesta nacional Colombia SABE. Se analizaron los determinantes estructurales como las variables demográficas y de situación socioeconómica. Las variables intermediarias se clasificaron en tres bloques: capacidad intrínseca, entorno físico y construido, y sistemas de atención de salud. El análisis de datos empleó la regresión logística con múltiples variables.La prevalencia de la discapacidad general fue de 21% en la actividad cotidiana, 38% en la actividad cotidiana instrumental y 33% en la discapacidad relacionada con la movilidad. Se asoció la discapacidad con los determinantes estructurales sociodemográficos, como edad avanzada, sexo femenino, residencia en entornos rurales, estar soltero o divorciado, vivir solo, un nivel educativo bajo y tener etnicidad indígena o negra. Con respecto a los determinantes relativos a la situación socioeconómica, la principal influencia en la discapacidad fueron los ingresos netos bajos, la situación socioeconómica baja, una percepción insuficiente de ingresos y un plan de seguro de salud subsidiado. Los determinantes intermediarios de la capacidad intrínseca, como la mala salud informada por la propia persona, la multimorbilidad, la poca fuerza en el puño, un estilo de vida sedentario, las adversidades económicas desde la primera infancia, la carencia de apoyo social y la falta de participación en actividades se asociaron de manera significativa con la discapacidad.Las medidas que tienen un efecto sobre los principales factores asociados con la discapacidad, como la reducción de las inequidades en materia de salud, mediante políticas, estrategias y actividades, pueden contribuir significativamente al bienestar y la calidad de vida de las personas mayores colombianas.Identificar os principais fatores associados à incapacidade em idosos na Colômbia, ajustados de acordo com os determinantes estruturais e intermediários do envelhecimento saudável.Este estudo usou dados transversais de 23.694 adultos com mais de 60 anos de idade que participaram da pesquisa nacionalA prevalência de incapacidade em geral foi de 21% para as atividades da vida diária, 38% para atividades instrumentais da vida diária e 33% para restrição de mobilidade. Constatou-se associação da incapacidade com determinantes estruturais sociodemográficos, como idade avançada, sexo feminino, residência em área rural, estado civil solteiro ou divorciado, viver sozinho, baixa escolaridade e etnia indígena/negra. Com relação aos determinantes da condição socioeconômica, baixa renda líquida, pertencimento ao estrato socioeconômico mais pobre, percepção de renda insuficiente e ter um plano de seguro-saúde subsidiado exerceram grande influência sobre a incapacidade. Determinantes intermediários da capacidade intrínseca, como autopercepção de saúde ruim, multimorbidade, força de preensão reduzida, estilo de vida sedentário, adversidade econômica na primeira infância, ausência de suporte social e não participação em atividades foram significativamente associados à incapacidade.Ações que afetem os principais fatores associados à incapacidade, como a redução das iniquidades em saúde por meio de políticas, estratégias e atividades, podem contribuir significativamente para o bem-estar e a qualidade de vida dos idosos colombianos.

Objective:To examine factors associated with visual impairment (VI) and eye care in the International Mobility in Aging Study (IMIAS). Method: IMIAS data were analyzed ( N = 1,995 with ages 65-74). Outcomes were VI defined as presenting visual acuity worse than 6/18 in the better eye and eye care utilization assessed by annual visits to eye care professionals. The Hurt–Insult–Threaten–Scream (HITS) questionnaire requested information on domestic violence. Results: Among men, VI varied from 24% in Manizales (Colombia) to 0.5% in Kingston (Canada); among women, VI ranged from 20% in Manizales to 1% in Kingston; lifetime exposure to domestic violence was associated with VI (odds ratio [OR] = 1.87; 95% confidence interval [CI] = [1.17, 3.00]). Eye care utilization varied from 72% in Kingston’s men to 25% in Tirana’s men; it was associated with domestic violence (prevalence ratio [PR] = 1.3; 95% CI = [1.1, 1.6]). Discussion: VI is more frequent where eye care utilization is low. Domestic violence may be a risk factor for VI.

Resumen Introducción. La estatura en el anciano no refleja su talla real de adulto joven debido al envejecimiento de su columna vertebral, entre otros aspectos. Objetivo. Proponer ecuaciones para estimar la talla de los ancianos colombianos mediante la altura de la rodilla, según el grupo étnico y el sexo. Materiales y métodos. Se hizo un análisis secundario del estudio transversal SABE 2015, utilizando un diseño muestral probabilístico y multietápico en personas colombianas de 60 o más años. Se seleccionaron aleatoriamente dos grupos de la base de datos del estudio SABE: el grupo para el desarrollo de las ecuaciones y el grupo para su validación. Se hizo un análisis de regresión lineal múltiple para estimar la estatura mediante la altura de la rodilla en los grupos étnicos (indígenas, afrodescendientes y blancos-mestizos) por edad y sexo; los resultados se validaron en cada subgrupo de estudio. Resultados. Se diseñaron seis ecuaciones por sexo (hombres=3.665, mujeres=3.019) y etnia; los coeficientes de determinación ajustados (R2 ) de las ecuaciones en hombres de los tres grupos étnicos oscilaron entre 64 y 75 % y, los errores estándar, entre 3,09 y 3,93 cm. En las mujeres, los R2 de las tres ecuaciones fluctuaron entre 53 y 73 % y los EE, entre 2,96 y 3,90 cm. Conclusión. La ecuación con mejor capacidad para estimar la talla del anciano colombiano fue la obtenida para los afrodescendientes de ambos sexos, en tanto que en la población indígena se presentaron los menores coeficientes de determinación. Abstract Introduction: The height in the elderly does not reflect their real size as young adults due to the aging of their spine, among other aspects. Objective: To estimate the equations to predict the height in Colombian elders according to their ethnic group and sex using the knee height measurement. Materials and methods: We conducted a secondary analysis of the SABE, 2015, crosssectional study using a multistage probabilistic sampling design in people aged 60 years and over in Colombia. We randomly selected two groups from the study’s database: A development group and a validation group of the equations. Age and anthropometric characteristics were similar in both groups. We performed a multiple linear regression analysis to predict the height using knee height measurement in the different ethnic groups (Indigenous, Afro-descendant, and white-mestizo groups) by age and sex; the results were validated in each selected subgroup. Results: We designed six equations by sex (men=3,665; women=3,019) and ethnic group. The adjusted R2 of the equations in men from the three ethnic groups oscillated between 64% and 75% and the standard errors, between 3,09 and 3,93 cm while in women, the R2 s of the three equations ranged between 53% and 73% and the EEs, between 2,96 and 3,90 cm. Conclusion: The equation with the best predictive capacity of the height of Colombian elders was obtained for African descendants of both sexes. The lowest coefficients of determination were obtained for the indigenous population.

OBJECTIVE To investigate the association between frailty and a summary cardiovascular risk measure (Framingham Risk Score, FRS) in a sample of older adults from different epidemiologic contexts participating in the multicenter International Mobility in Aging Study (IMIAS). MATERIAL AND METHODS This cross-sectional study used data from the IMIAS, which is composed of older adults from four different countries (Canada, Albania, Colombia and Brazil). A total of 1724 older adults aged 65-74 years were assessed. Frailty was defined as the presence of 3 or more of the following criteria: unintentional weight loss in the last year, exhaustion, muscle weakness, slowness in gait speed, and low levels of physical activity. The FRS was calculated to estimate the 10-year risk for cardiovascular disease (CVD), based on: sex, age, systolic blood pressure (SBP), and treatment for hypertension, total and high-density lipoprotein (HDL) cholesterol, diabetes mellitus status and smoking habits. Confounders included measures of childhood social and economic adversity, as well as mid-life and adult adversity. RESULTS After adjustment for adversities which occurred during in early, adult or current life, frail individuals presented higher FRS values (β = 3.81, 95 %CI: 0.97-6.65, p-value

Introduction: The height in the elderly does not reflect their real size as young adults due to the aging of their spine, among other aspects. Objective: To estimate the equations to predict the height in Colombian elders according to their ethnic group and sex using the knee height measurement. Materials and methods: We conducted a secondary analysis of the SABE, 2015, crosssectional study using a multistage probabilistic sampling design in people aged 60 years and over in Colombia. We randomly selected two groups from the study’s database: A development group and a validation group of the equations. Age and anthropometric characteristics were similar in both groups. We performed a multiple linear regression analysis to predict the height using knee height measurement in the different ethnic groups (Indigenous, Afro-descendant, and white-mestizo groups) by age and sex; the results were validated in each selected subgroup. Results: We designed six equations by sex (men=3,665; women=3,019) and ethnic group. The adjusted R2 of the equations in men from the three ethnic groups oscillated between 64% and 75% and the standard errors, between 3,09 and 3,93 cm while in women, the R2s of the three equations ranged between 53% and 73% and the EEs, between 2,96 and 3,90 cm. Conclusion: The equation with the best predictive capacity of the height of Colombian elders was obtained for African descendants of both sexes. The lowest coefficients of determination were obtained for the indigenous population.Introducción. La estatura en el anciano no refleja su talla real de adulto joven debido al envejecimiento de su columna vertebral, entre otros aspectos. Objetivo. Proponer ecuaciones para estimar la talla de los ancianos colombianos mediante la altura de la rodilla, según el grupo étnico y el sexo. Materiales y métodos. Se hizo un análisis secundario del estudio transversal SABE 2015, utilizando un diseño muestral probabilístico y multietápico en personas colombianas de 60 o más años. Se seleccionaron aleatoriamente dos grupos de la base de datos del estudio SABE: el grupo para el desarrollo de las ecuaciones y el grupo para su validación. Se hizo un análisis de regresión lineal múltiple para estimar la estatura mediante la altura de la rodilla en los grupos étnicos (indígenas, afrodescendientes y blancos-mestizos) por edad y sexo; los resultados se validaron en cada subgrupo de estudio. Resultados. Se diseñaron seis ecuaciones por sexo (hombres=3.665, mujeres=3.019) y etnia; los coeficientes de determinación ajustados (R2) de las ecuaciones en hombres de los tres grupos étnicos oscilaron entre 64 y 75 % y, los errores estándar, entre 3,09 y 3,93 cm. En las mujeres, los R2 de las tres ecuaciones fluctuaron entre 53 y 73 % y los EE, entre 2,96 y 3,90 cm. Conclusión. La ecuación con mejor capacidad para estimar la talla del anciano colombiano fue la obtenida para los afrodescendientes de ambos sexos, en tanto que en la población indígena se presentaron los menores coeficientes de determinación.

Objective: The objective of this study is to evaluate the influence of urinary incontinence (UI) on physical performance. Method: In prospective analyses from the International Mobility in Aging Study (IMIAS), 915 women (65-74 years) from Canada, Colombia, Albania, and Brazil were evaluated in relation to self-reported UI (past week) and physical performance (Short Physical Performance Battery [SPPB]), with reevaluation after 2 years. Linear mixed models examined the influence of UI on SPPB, adjusted by covariates (age, study site, education, income sufficiency, body mass index [BMI] and parity). Results: Women reporting some UI presented lower SPPB mean (β = −0.41, p = .009) and a greater reduction (β = −0.53, p = .001) over 2 years than those reporting no UI. Discussion: Compared with no reported UI, some UI was associated with worse and more pronounced declines in physical performance over 2 years. This study highlights the importance of practices to reduce UI to contribute to healthier aging.

Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults. Introducción: El auto-reporte de salud (SRH) se ha considerado un marcador importante de calidad de vida y un factor predictor independiente de mortalidad en adultos mayores. Objectivo: Determinar la prevalencia de SRH pobre e identificar los factores de riesgo asociados con ARS pobre en adultos mayores que viven en la Comuna 18 de la ciudad de Cali, Colombia, en 2009. Métodos: Un estudio poblacional de corte transversal con un diseño de muestreo por conglomerado monoetápico. La muestra incluyó 314 personas de 60 años o más. La variable dependiente, SRH fue dicotomizada en buena (excelente, muy buena y buena) y pobre (regular or mala). Las variables independientes fueron sociodemográficas, biológicas, mentales, funcionales y síndromes geriátricos. La regresión logística fue usada para modelos estadísticos multivariados. Resultados: En general, 40.1% reportaron SRH pobre (mujeres 42.9%, hombres 35.0%). Los factores asociados independientemente con SRH pobre fueron diabetes mellitus, depresión, temor a caer y síndrome de fragilidad (frágil and pre-frágil vs. no-frágil). Los hombres viudos reportaron mas SRH pobre comparados con hombres casados, mientras teniendo otro estado marital (soltero, separado, divorciado) fue asociado con menos SRH pobre en mujeres. Conclusión: Factores potencialmente modificables tales como la depresión y el síndrome de fragilidad son determinantes importantes de una pobre SRH en adultos mayores colombianos.

Background Life course exposure to violence may lead to disability in old age. We examine associations and pathways between life course violence and mobility disability in older participants of the International Mobility in Aging Study (IMIAS). Methods A cross-sectional study using IMIAS 2012 baseline. Men and women aged 65–74 years were recruited at 5 cities (n=1995): Kingston and Saint-Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia) and Natal (Brazil). Mobility was assessed by the Short Physical Performance Battery (SPPB) and by 2 questions on difficulty in walking and climbing stairs. Childhood physical abuse history and the HITS instrument were used to gather information on childhood exposure to violence and violence by intimate partners or family members. Multivariate logistic regression and mediation analysis models were constructed to explore the significance of direct and indirect effects of violence on mobility. Interaction effects of gender on violence and on each of the mediators were tested. Results Experiences of physical violence at any point of life were associated with mobility disability (defined as SPPB

Objectives To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults. Design Cross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living. Setting Kingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil. Participants 1600 community-dwelling adults aged 65–74 years, n=400 at each site. Outcome measures Likert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale. Results Relationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67). Conclusions Among older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and partner were associated with less depression and better QoL.

Dizziness is a common symptom in older adults. The majority of those with dizziness tend to have more than one risk factor, suggesting that dizziness is a multifactorial geriatric condition. Therefore, associated factors must be determined to permit risk-reduction approaches. To examine the associations between dizziness and socio-demographic, physical, functional and psychological health factors among older persons living in the Andes Mountains. Population-based cross-sectional study. One thousand six hundred ninety-two community-living people aged 60 years and over living in four rural and suburban areas of villages in coffee-grower zones in the Colombian Andes Mountains. Outcome measures included self-reporting of dizziness as a symptom experienced either very frequently or continuously during the last month. Independent variables were demographic, socioeconomic and social factors; disease and biomedical factors; functional status and performance-based measures; and psychological factors such as depressive symptoms and self-rated health. Dizziness was reported by 15.2% of participants in the study. Variables independently associated with dizziness were: number of chronic conditions, visual impairment, and use of more than four medications. Independently associated psychological variables were: poor self-perceived health, cognitive impairment and depression. Health and psychological factors accounted for 85% of dizziness. Older persons who reported dizziness were more physically frail, with more instances of chronic conditions and sensory impairments, and had poor self-perceptions of their health. Biomedical and psychological factors showed a strong independent association with dizziness. A multifactorial intervention targeting the identified factors would reduce dizziness in older people. However, this approach may need to address different sets of specific factors related to the dizziness categories.

Objective: This study aimed to determine the prevalence of successful aging (SA) and identify its predictive factors in a cohort of older people in the Colombian Andes Mountain. Method: Data were drawn from a prospective longitudinal study of community-dwelling elderly people in Manizales. SA encompassed indicators in four domains: physical, cognitive, emotional, and social functioning. Results: The prevalence of SA was 24.4%. The independent predictors were good and very good self-rated health, middle–high/high-income level, absence of chronic conditions, married status, high educational level, and very high spirituality. Discussion: The prevalence of SA was low: One of 10 people older than 65 years showed SA when presence of diseases was included in the criteria, compared with one of four when such an item was excluded. The identification of predictive factors allows distinguishing this population in primary care services and promoting strategies that ensure high functionality levels for as long as possible.

Objective: This study examines the associations between activity restriction related to fear of falling and sociodemographic and health factors among people aged 60 and older living in the Colombian Andes mountains. Method: The sample includes 1,668 community-living participants. Outcomes included no fear of falling, fear of falling alone, or activity restriction related to fear of falling. Results: Fear of falling was reported by 83.3%, and of these 52.2% reported activity restriction. Independent factors for activity restriction (vs. fear of falling alone) were low income, functional difficulty, falling or decreasing physical activity, polypharmacy, poor self-perceived health, and depression. Discussion: The prevalence of overall fear of falling and related activity restriction was surprisingly high because this is a physically active population. Participants with activity restriction related to fear of falling have decreased physical activity or functional status, poor self-perceived health, and worse depressive symptoms than those who have fear of falling alone.

PURPOSE: To determine whether gender, socioeconomic conditions, and/or social relations are related to recent experiences of DV in older adult populations. MATERIALS AND METHODS: Data on socioeconomic status and social relations were collected in 2012 from 1995 community-dwelling older adults in Canada, Colombia, Brazil, and Albania. Violence experienced in the last 6 months was measured using the Hurt, Insulted, Threatened with harm, or Screamed at (HITS) scale and classified according to type (physical or psychological) and perpetrator (partner or family member). Binary logistic regression analyses were used to assess associations between experiences of violence and gender, socioeconomic conditions, and social relations. RESULTS: Physical violence (by partner or family member) was reported by 0.63-0.85% of participants; the prevalence of psychological violence (by partner or family member) ranged from 3.2% to 23.5% in men and 9% to 26% in women. After adjustment for socioeconomic status, social relations, age and site, women experienced more psychological violence perpetrated by family members than did men (odds ratio (OR): 1.8; 95% CI: 1.2-2.6). Social relations, such as multifamily living arrangements and low levels of support from partners, children, and family, were associated with psychological DV. Current working status was associated with greater odds of victimization by partners among men (OR: 2.35 95% CI: 1.34-1.41), but not among women. CONCLUSIONS: Gender and social relations are important determinants of experiencing violence in older adults. The findings of this study demonstrate the importance of a gender-based approach to the study of DV in older adults. Language: en

Background This study aimed to estimate the prevalence and associated factors related to frailty, by Fried criteria, in the elderly population in a rural area in the Andes Mountains, and to analyze the relationship of these with comorbidity and disability. Methods A cross-sectional study was undertaken involving 1878 participants 60 years of age and older. The frailty syndrome was diagnosed based on the Fried criteria (weakness, low speed, low physical activity, exhaustion, and weight loss). Variables were grouped as theoretical domains and, along with other potential confounders, were placed into five categories: (a) demographic and socioeconomic status, (b) health status, (c) self-reported functional status, (d) physical performance-based measures, and (e) psychosocial factors. Chi-square, ANOVA, and multinomial logistic regression analyses were used to test the prognostic value of frailty for the outcomes of interest. Results The prevalence of frailty was 12.2%. Factors associated with frailty were age, gender, health status variables that included self-perceived health and number of chronic conditions, functional covariate variables that included disability in activities in daily living (ADL), disabilities in instrumental ADL, chair stand time, and psychosocial variables that included depressive symptoms and cognitive impairment. Higher comorbidity and disability was found in frail elderly people. Only a subset of frail elderly people (10%) reported no disease or disability. Conclusions A relevant number of elderly persons living in rural areas in the Andes Mountains are frail. The prevalence of frailty is similar to that reported in other populations in the Latin American region. Our results support the use of modified Cardiovascular Health Study criteria to measure frailty in communities other than urban settings. Frailty in this study was strongly associated with comorbidities, and frailty and comorbidity predicted disability.

The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults.

Objectives: To assess the validity (convergent and construct) and reliability of the Short Physical Performance Battery (SPPB) among non-disabled adults between 65 to 74 years of age residing in the Andes Mountains of Colombia. Methods: Design: Validation study; Participants: 150 subjects aged 65 to 74 years recruited from elderly associations (day-centers) in Manizales, Colombia. Measurements: The SPPB tests of balance, including time to walk 4 meters and time required to stand from a chair 5 times were administered to all participants. Reliability was analyzed with a 7-day interval between assessments and use of repeated ANOVA testing. Construct validity was assessed using factor analysis and by testing the relationship between SPPB and depressive symptoms, cognitive function, and self rated health (SRH), while the concurrent validity was measured through relationships with mobility limitations and disability in Activities of Daily Living (ADL). ANOVA tests were used to establish these associations. Results: Test-retest reliability of the SPPB was high: 0.87 (CI95%: 0.77-0.96). A one factor solution was found with three SPPB tests. SPPB was related to self-rated health, limitations in walking and climbing steps and to indicators of disability, as well as to cognitive function and depression. There was a graded decrease in the mean SPPB score with increasing disability and poor health. Conclusion: The Spanish version of SPPB is reliable and valid to assess physical performance among older adults from our region. Future studies should establish their clinical applications and explore usage in population studies. Resumen Objetivos: Evaluar la validez convergente y de constructo, y la confiabilidad de la Batería Corta de desempeño físico (Short Physical Performance Battery -SPPB-) entre ancianos no discapacitados entre 65 a 74 años, en los Andes Colombianos. Métodos: 150 ancianos entre 65-74 años reclutados de los centros-día de la ciudad de Manizales, Colombia. Las pruebas del SPPB: equilibrio, caminar 4 m. y el tiempo para incorporarse 5 veces de una silla se aplicaron a todos los participantes. La fiabilidad fue medida con un intervalo de 7 días entre las evaluaciones, y analizada con Anova de medidas repetidas. La validez de constructo fue evaluada mediante análisis factorial y relaciones entre el SPPB con la función cognoscitiva, síntomas de depresión, auto-percepción de salud, y factores sociales; y la validez convergente mediante asociaciones con las limitaciones de movilidad y discapacidad en las Actividades de la Vida Diaria (AVD), para estos últimos análisis se usaron Test de ANOVA. Resultados: La fiabilidad del SPPB test-retest fue muy buena, 0.87 (IC95%: 0.77- 0.93). Las tres pruebas del SPPB resultaron en un solo factor. El SPPB mostró una relación con limitación en la marcha y para subir escaleras, así como con los indicadores de discapacidad, función cognoscitiva y depresión. Existe una disminución gradual del puntaje de SPPB al aumentar la discapacidad y la mala auto-percepción de salud. Conclusión: La versión en español de la Batería Corta de Desempeño físico (SPPB) demostró ser válida y confiable para evaluar el desempeño físico en ancianos en los Andes Colombianos.

Fernando Gomez,1,2 Carmen Lucia Curcio,1 Pushpa Suriyaarachchi,2 Oddom Demontiero,2 Gustavo Duque2 1Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University of Caldas, Manizales, Colombia; 2Ageing Bone Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, Australia Abstract: Falls and fractures are major causes of morbidity and mortality in older people. More importantly, previous falls and/or fractures are the most important predictors of further events. Therefore, secondary prevention programs for falls and fractures are highly needed. However, the question is whether a secondary prevention model should focus on falls prevention alone or should be implemented in combination with fracture prevention. By comparing a falls prevention clinic in Manizales (Colombia) versus a falls and fracture prevention clinic in Sydney (Australia), the objective was to identify similarities and differences between these two programs and to propose an integrated model of care for secondary prevention of fall and fractures. A comparative study of services was performed using an internationally agreed taxonomy. Service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE) and previous reports in the literature. Comparison included organization, administration, client characteristics, and interventions. Several similarities and a number of differences that could be easily unified into a single model are reported here. Similarities included population, a multidisciplinary team, and a multifactorial assessment and intervention. Differences were eligibility criteria, a bone health assessment component, and the therapeutic interventions most commonly used at each site. In Australia, bone health assessment is reinforced whereas in Colombia dizziness assessment and management is pivotal. The authors propose that falls clinic services should be operationally linked to osteoporosis services such as a "falls and fracture prevention clinic," which would facilitate a comprehensive intervention to prevent falls and fractures in older persons. Keywords: outpatient clinics, falls and fracture services, geriatric health services, secondary prevention

OBJECTIVE: Describe the prevalence of domestic violence in older men and women in Natal, Brazil, and Manizales, Colombia and explore whether the differences by gender are due to lifetime differences in social and financial status. METHODS: Cross-sectional study with a random sampling of 802 men and women in the IMIAS Study (International Mobility in Aging Study) (65-74 years old) conducted in Natal (Brazil) and Manizales (Colombia). Incidents that occurred in the last six months and any time during their lives were evaluated using the HITS scale. Poisson regression was used to estimate the reasons for the prevalence of violence against women by men. RESULTS: Experience of physical violence occurring any time in life ranged from 2.2% to 18.3%, depending on the city and the sex. Psychological violence was higher in women: violence perpetrated by partners affected 25.7% of women in Natal and 19.4% in Manizales; and by the family, 18.3% in Manizales and 10% in Natal. Almost half of the participants reported suffering psychological violence at some time during their life. Experience of current violence or at some time during life was most frequent in women, even after adjustment for co-variables, with prevalence ratios of 1.60 to 2.14. CONCLUSIONS: The rates of prevalence of domestic violence in older adults show that women are more affected, which means that they should be considered a priority in the prevention policies on Latin America's health agenda.