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Timely and accurate diagnosis of Alzheimer's disease (AD) in clinical practice remains challenging. PET and CSF biomarkers are the most widely used biomarkers to aid diagnosis in clinical research but present limitations for clinical practice (i.e., cost, accessibility). Emerging blood-based markers have the potential to be accurate, cost-effective, and easily accessible for widespread clinical use, and could facilitate timely diagnosis. The EU/US CTAD Task Force met in May 2022 in a virtual meeting to discuss pathways to implementation of blood-based markers in clinical practice. Specifically, the CTAD Task Force assessed: the state-of-art for blood-based markers, the current use of blood-based markers in clinical trials, the potential use of blood-based markers in clinical practice, the current challenges with blood-based markers, and the next steps needed for broader adoption in clinical practice.

OBJECTIVES: To determine the relationship between apolipoprotein E (APOE) epsilon4 and Alzheimer's disease (AD) in the Mexican Mestizo population, as well as its effects on the cognitive profile of AD and elderly Mestizos without dementia. DESIGN: Cross-sectional analysis of a cohort study. SETTING: Evaluations were conducted at the geriatrics clinic of an academic medical hospital in Mexico City. PARTICIPANTS: Forty-nine elderly subjects with AD and 141 controls selected from a representative sample of Mexican Mestizos aged 65 to 96 who participated in the Prevalence Survey of Dementia in the Mexico City Elderly Population cohort. MEASUREMENTS: All subjects underwent APOE genotypification and a comprehensive clinical and neuropsychological evaluation. RESULTS: There were no significant differences in epsilon3 and epsilon4 frequencies between the subjects with and without AD and a tendency toward higher epsilon4 and lower epsilon3 allele frequencies in subjects aged 75 and older. No association was found between APOE epsilon4 and the presence of AD. The age-, sex-, and education-adjusted risk for AD associated with at least one epsilon4 allele was 1.01 (95% confidence interval=0.45-2.23). Performance on a long-term visual memory test was significantly worse in APOE epsilon4 carriers than in APOE epsilon3 carriers only in the group with AD. CONCLUSION: APOE epsilon4 did not increase the risk for AD in this Mexican Mestizo elderly urban population sample, although the presence of this allele seems to modify its clinical expression. [ABSTRACT FROM AUTHOR]

Introduction: Undernutrition risk in adults is a common but undiagnosed condition, while obesity is highly prevalent in this population. Osteosarcopenia is the coexistence of sarcopenia and osteopenia/osteoporosis and is related to higher morbidity and mortality. Undernutrition has been identified as an associated factor of osteosarcopenia; however, it is unknown whether undernutrition risk is also related to this condition. On the other hand, obesity has been associated with osteosarcopenia, and several biological mechanisms in the relationship between muscle, bone, and fat have been identified. However, in both cases, there is a lack of longitudinal studies that allow evaluation of whether these conditions precede and increase the risk of osteosarcopenia. Therefore, the objective was to evaluate the association between undernutrition risk and obesity with osteosarcopenia among Mexican community-dwelling adults aged 50 and over., Methods: This is a secondary longitudinal study from the FraDySMex cohort. We considered data from 2014 and 2015 as baseline evaluations and 2019 as the follow-up evaluation. Undernutrition risk was assessed using the Mini Nutritional Assessment, obesity was assessed based on body fat percentage measured by DXA, and osteosarcopenia was diagnosed according to the FNIH criteria. To evaluate the association of obesity and undernutrition risk, we estimated mixed-effects logistic regression models. The final model was adjusted for sex, age, comorbidity, education, physical activity, and cognitive impairment., Results: A total of 304 participants with two evaluations (baseline and follow-up) were included in the study. The baseline mean age of participants was 69.6 years (SD 9.1), with ages ranging from 50 to 92 years. Most of the participants were female (83.2%), 40% had between 7 and 12 years of education, and almost half were categorized as sedentary (47.8%) at baseline evaluation. Both undernutrition risk and obesity increased the risk of osteosarcopenia, with an OR of 2.24 (95% CI: 1.20-4.19) and an OR of 2.22 (95% CI: 1.17-4.23), respectively., Conclusion: Our findings suggest that undernutrition risk, on the one hand, and obesity, on the other hand, can precede and increase the risk of osteosarcopenia in community-dwelling adults aged 50 and over., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Omaña-Guzmán, Kammar-García, Gutierrez-Robledo and Rosas-Carrasco.)

Background: The Decade of Healthy Aging (2021-2030) emerges as a 10 years strategy to improve the lives of older adults, their families, and the communities in which they live. One of the actions defined in this framework is related to improving the measurement, monitoring, and understanding of characteristics, factors, and needs related to aging and health. The aim was to analyze and assess the process of construction and development of the Strategic Information System on Health, Funcional Dependence and Aging (SIESDE, for its acronym in Spanish). SIESDE will provide strategic information in Mexico at the municipal, state, and national levels that support the public policies on healthy aging., Methods: The system processes and analyzes the data sources of the Health Information Systems and the National System of Statistical and Geographical Information. SIESDE comprises three components: (1) Design, construction, and evaluation of the indicators; (2) storage, management, and visualization, and (3) diffusion and translation of information., Results: A total of 135 indicators were built on seven themes: (1) demographic, socioeconomic, and aging conditions, (2) health, (3) functional dependence, (4) healthy aging, (5) health services, (6) social and physical environments, and (7) complex indicators., Conclusions: SIESDE is an effective system for providing an overall view of health, aging, and functional dependence., (© 2024. The Author(s).)

Objetivo: Estimar la proporción de sujetos vacunados y los factores asociados en personas adultas y adultas mayores en México. Material y métodos. Análisis de datos obtenidos de la Encuesta Nacional de Salud y Nutrición Continua 2021-2023 (Ensanut Continua 2021-2023) y analizar las variaciones comparando con la Ensanut 2012., Resultados: Dado que solamente el 6.8% de personas adultas y adultas mayores en Ensanut Continua 2021-2023 y 17.7% en Ensanut 2012 acreditaron su estado de vacunación, el análisis se basa en autorreporte. Al comparar Ensanut Continua 2021-2023 con Ensanut 2012, la proporción de sujetos vacunados de acuerdo con grupo de edad y biológico fue la siguiente: personas de 20-59 años, tétanos: 66.87 vs. 78.08%; mujeres en edad fértil, tétanos: 71.1 vs. 82.0%; sarampión/rubéola: 36.8 vs. 48.5%; adultos mayores: tétanos: 59.5 vs. 65.86%; influenza 58.7 vs. 51.9%; neumococo 34.8 vs. 45.9%. La cobertura para vacuna contra Covid-19 en adultos jóvenes y mayores fue de 86.6 y 89.2%, respectivamente. Las características más prevalentes entre los adultos de 20-59 años con esquemas incompletos fueron ser hombre, no tener derechohabiencia y tener trabajo remunerado; en los adultos ≥ 60 años fue no tener derechohabiencia. Discusión. Una proporción considerable de personas adultas y adultas mayores no están protegidos contra enfermedades prevenibles por vacunación en 2021-2023.

Aim: To evaluate the readiness of the Mexican healthcare system to implement the integrated care for older people (ICOPE) approach into an existing healthcare model., Methods: We conducted a cross-sectional study with data from 2473 healthcare workers analyzed using the model for understanding success in quality (MUSIQ) framework to gather data from healthcare professionals. Their perceptions regarding the readiness for ICOPE were assessed across five dimensions: team, microsystem, infrastructure, organization, and external environment., Results: Only 717 (29%) of the participants believed ICOPE could be successfully implemented in Mexico without any modifications. A total of 1261 (51%) participants rated the readiness of ICOPE with some barriers. The main barriers were reallocating resources and the external environment., Observation: Mexico's healthcare system faces barriers to innovation that could hinder the successful integration of the ICOPE approach. A systematic identification of these barriers provides an opportunity to suggest adaptations and refinements to increase the probability of success. Using the contextual factors identified as facilitators and the proposal of interventions such as the ICOPE app could improve the chances of success., Conclusion: The participants of this study evaluated ICOPE as ready to implement, with some contextual barriers. The readiness evaluation supports the stakeholders' and policymakers' decisions in implementing and monitoring the program in a natural setting. Evaluating the readiness of the intervention increases the possibility of aligning the innovation with contextual factors, increasing the chances of its successful adoption and implementation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Gutierrez et al.)

Adverse conditions in early life, including environmental, biological and social influences, are risk factors for ill-health during aging and the onset of age-related disorders. In this context, the recent field of social epigenetics offers a valuable method for establishing the relationships among them However, current clinical studies on environmental changes and lifespan disorders are limited. In this sense, the Tlaltizapan (Mexico) cohort, who 52 years ago was exposed to infant malnutrition, low income and poor hygiene conditions, represents a vital source for exploring such factors. Therefore, in the present study, 52 years later, we aimed to explore differences in clinical/biochemical/anthropometric and epigenetic (DNA methylation) variables between individuals from such a cohort, in comparison with an urban-raised sample. Interestingly, only cholesterol levels showed significant differences between the cohorts. On the other hand, individuals from the Tlaltizapan cohort with more years of schooling had a lower epigenetic age in the Horvath ( p -value = 0.0225) and PhenoAge ( p -value = 0.0353) clocks, compared to those with lower-level schooling. Our analysis indicates 12 differentially methylated sites associated with the PI3-Akt signaling pathway and galactose metabolism in individuals with different durations of schooling. In conclusion, our results suggest that longer durations of schooling could promote DNA methylation changes that may reduce epigenetic age; nevertheless, further studies are needed.

The aging process has been linked to the occurrence of chronic diseases and functional impairments, including cancer, sarcopenia, frailty, metabolic, cardiovascular, and neurodegenerative diseases. Nonetheless, aging is highly variable and heterogeneous and represents a challenge for its characterization. In this sense, intrinsic capacity (IC) stands as a novel perspective by the World Health Organization, which integrates the individual wellbeing, environment, and risk factors to understand aging. However, there is a lack of quantitative and qualitative attributes to define it objectively. Therefore, in this review we attempt to summarize the most relevant and promising biomarkers described in clinical studies at date over different molecular levels, including epigenomics, transcriptomics, proteomics, metabolomics, and the microbiome. To aid gerontologists, geriatricians, and biomedical researchers to understand the aging process through the IC. Aging biomarkers reflect the physiological state of individuals and the underlying mechanisms related to homeostatic changes throughout an individual lifespan; they demonstrated that aging could be measured independently of time (that may explain its heterogeneity) and to be helpful to predict age-related syndromes and mortality. In summary, we highlight the areas of opportunity and gaps of knowledge that must be addressed to fully integrate biomedical findings into clinically useful tools and interventions., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Hypertension is associated with insulin resistance (IR), metabolic syndrome (MS), and arterial stiffness. Non-insulin-based IR indexes were developed as tools for metabolic screening. Here, we aimed to evaluate the novel non-insulin-based Metabolic Score for IR (METS-IR) index for the prediction of incident hypertension and arterial stiffness evaluated using pulse wave velocity (PWV) analysis, compared with other non-insulin-based IR indexes. We evaluated two populations, a cross-sectional evaluation of high-risk individuals (n = 305) with a wide range of metabolic comorbidities and dyslipidemia in whom PWV measurement was performed and a 3-year prospective cohort of normotensive individuals (N = 6850). We observed a positive correlation between METS-IR and PWV in the cross-sectional cohort, which was higher compared with other non-insulin-based fasting IR indexes; furthermore, PWV values >75th percentile were associated with the upper tercile of METS-IR values. In the prospective cohort, we observed an increased risk for incident hypertension for the upper METS-IR tercile (METS-IR ≥ 46.42; HR: 1.81, 95% CI: 1.41-2.34), adjusted for known cardiovascular risk factors, and observed that METS-IR had greater increases in the predictive capacity for hypertension along with SBP and the Framingham Hypertension Risk Prediction Model compared with other non-insulin-based IR indexes. Therefore, METS-IR is a novel non-insulin-based IR index which correlates with arterial stiffness and is a predictor of incident hypertension, complementary to previously validated risk prediction models., (©2019 Wiley Periodicals, Inc.)

Frailty is an age-associated condition, characterized by an inappropriate response to stress that results in a higher frequency of adverse outcomes (e.g., mortality, institutionalization and disability). Some light has been shed over its genetic background, but this is still a matter of debate. In the present study, we used network biology to analyze the interactome of frailty-related genes at different levels to relate them with pathways, clinical deficits and drugs with potential therapeutic implications. Significant pathways involved in frailty: apoptosis, proteolysis, muscle proliferation, and inflammation; genes as FN1, APP, CREBBP, EGFR playing a role as hubs and bottlenecks in the interactome network and epigenetic factors as HIST1H3 cluster and miR200 family were also involved. When connecting clinical deficits and genes, we identified five clusters that give insights into the biology of frailty: cancer, glucocorticoid receptor, TNF-α, myostatin, angiotensin converter enzyme, ApoE, interleukine-12 and -18. Finally, when performing network pharmacology analysis of the target nodes, some compounds were identified as potentially therapeutic (e.g., epigallocatechin gallate and antirheumatic agents); while some other substances appeared to be toxicants that may be involved in the development of this condition.

Background: Type 2 diabetes mellitus (T2D) is a leading cause of morbidity and mortality in Mexico. Here, we aimed to report incidence rates (IR) of type 2 diabetes in middle-aged apparently-healthy Mexican adults, identify risk factors associated to ID and develop a predictive model for ID in a high-risk population., Methods: Prospective 3-year observational cohort, comprised of apparently-healthy adults from urban settings of central Mexico in whom demographic, anthropometric and biochemical data was collected. We evaluated risk factors for ID using Cox proportional hazard regression and developed predictive models for ID., Results: We included 7636 participants of whom 6144 completed follow-up. We observed 331 ID cases (IR: 21.9 per 1000 person-years, 95%CI 21.37-22.47). Risk factors for ID included family history of diabetes, age, abdominal obesity, waist-height ratio, impaired fasting glucose (IFG), HOMA2-IR and metabolic syndrome. Early-onset ID was also high (IR 14.77 per 1000 person-years, 95%CI 14.21-15.35), and risk factors included HOMA-IR and IFG. Our ID predictive model included age, hypertriglyceridemia, IFG, hypertension and abdominal obesity as predictors (D xy  = 0.487, c-statistic = 0.741) and had higher predictive accuracy compared to FINDRISC and Cambridge risk scores., Conclusions: ID in apparently healthy middle-aged Mexican adults is currently at an alarming rate. The constructed models can be implemented to predict diabetes risk and represent the largest prospective effort for the study metabolic diseases in Latin-American population.

An opportune early diagnosis of Alzheimer's disease (AD) would help to overcome symptoms and improve the quality of life for AD patients. Research studies have identified early manifestations of AD that occur years before the diagnosis. For instance, eye movements of people with AD in different tasks differ from eye movements of control subjects. In this review, we present a summary and evolution of research approaches that use eye tracking technology and computational analysis to measure and compare eye movements under different tasks and experiments. Furthermore, this review is targeted to the feasibility of pioneer work on developing computational tools and techniques to analyze eye movements under naturalistic scenarios. We describe the progress in technology that can enhance the analysis of eye movements everywhere while subjects perform their daily activities and give future research directions to develop tools to support early AD diagnosis through analysis of eye movements.

This article reports the findings of a survey on end-of-life (EOL) care in nursing homes of 18 long-term care experts across 15 countries. The experts were chosen as a convenience-based sample of known experts in each country. The survey was administered in 2016 and included both open-ended responses for defining hospice care, palliative care, and "end of life," and a series of questions related to the following areas-attitudes toward EOL care, current practice and EOL interventions, structure of care, and routine barriers. Overall experts strongly agreed that hospice and palliative care should be available in long-term care facilities and that both are defined by holistic, interdisciplinary approaches using measures of comfort across domains. However, it appears the experts felt that in most countries the reality fell short of what they believed would be ideal care. As a result, experts call for increased training, communication, and access to specialized EOL services within the nursing home., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

The absolute and relative increases in the number of older persons are evident worldwide, from the most developed countries to the lowest-income regions. Multimorbidity and need for social support increase with age. Age-related conditions and, in particular, disabilities are a significant burden for the person, his or her family, and public health care systems. To guarantee the sustainability of public health systems and improve the quality of care provided, it is becoming urgent to act to prevent and delay the disabling cascade. Current evidence shows that too large a proportion of community-dwelling older people present risk factors for major health-related events and unmet clinical needs. In this scenario, the "frailty syndrome" is a condition of special interest. Frailty is a status of extreme vulnerability to endogenous and exogenous stressors exposing the individual to a higher risk of negative health-related outcomes. Frailty may represent a transition phase between successful aging and disability, and a condition to target for restoring robustness in the individual at risk. Given its syndromic nature, targeting frailty requires a comprehensive approach. The identification of frailty as a target for implementing preventive interventions against age-related conditions is pivotal. Every effort should be made by health care authorities to maximize efforts in this field, balancing priorities, needs, and resources. Raising awareness about frailty and age-related conditions in the population is important for effective prevention, and should lead to the promotion of lifelong healthy behaviors and lifestyle., (Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

23% of the total global burden of disease is attributable to disorders in people aged 60 years and older. Although the proportion of the burden arising from older people (≥60 years) is highest in high-income regions, disability-adjusted life years (DALYs) per head are 40% higher in low-income and middle-income regions, accounted for by the increased burden per head of population arising from cardiovascular diseases, and sensory, respiratory, and infectious disorders. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%). A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people. Primary prevention in adults aged younger than 60 years will improve health in successive cohorts of older people, but much of the potential to reduce disease burden will come from more effective primary, secondary, and tertiary prevention targeting older people. Obstacles include misplaced global health priorities, ageism, the poor preparedness of health systems to deliver age-appropriate care for chronic diseases, and the complexity of integrating care for complex multimorbidities. Although population ageing is driving the worldwide epidemic of chronic diseases, substantial untapped potential exists to modify the relation between chronological age and health. This objective is especially important for the most age-dependent disorders (ie, dementia, stroke, chronic obstructive pulmonary disease, and vision impairment), for which the burden of disease arises more from disability than from mortality, and for which long-term care costs outweigh health expenditure. The societal cost of these disorders is enormous., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Little is known about the contribution of frailty in improving patient-level prediction beyond readily available clinical information. The objective of this study is to compare the predictive ability of 129 combinations of seven frailty markers (cognition, energy, mobility, mood, nutrition, physical activity, and strength) and quantify their contribution to predictive accuracy beyond age, sex, and number of chronic diseases., Methods: Two cohorts from the Established Populations for Epidemiologic Studies of the Elderly were used. The model with the best predictive fit in predicting 6-year incidence of disability was determined using the Akaike Information Criterion. Predictive accuracy was measured by the C statistic., Results: Incident disability was 23% in one cohort and 20% in the other cohort. The "best model" in each cohort was found to be a model including between five and seven frailty markers including cognition, mobility, nutrition, physical activity, and strength. Predictive accuracy of the 129 models ranged from 0.73 to 0.77 across both cohorts. Adding frailty markers to age, sex, and chronic disease increased predictive accuracy by up to 3% in both cohorts (p < .001). The contribution of frailty increased up to 9% in the oldest age group., Conclusions: Adding frailty markers provided a modest increase in patient-level prediction of disability. Such a modest increase may still be worthwhile because while age, sex, and the number of chronic diseases are not modifiable, frailty may be. Further studies examining the contribution of frailty in improving prediction are needed before adopting frailty as a prognostic tool.

Frailty is a clinical state in which there is an increase in an individual's vulnerability for developing increased dependency and/or mortality when exposed to a stressor. Frailty can occur as the result of a range of diseases and medical conditions. A consensus group consisting of delegates from 6 major international, European, and US societies created 4 major consensus points on a specific form of frailty: physical frailty. 1. Physical frailty is an important medical syndrome. The group defined physical frailty as "a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death." 2. Physical frailty can potentially be prevented or treated with specific modalities, such as exercise, protein-calorie supplementation, vitamin D, and reduction of polypharmacy. 3. Simple, rapid screening tests have been developed and validated, such as the simple FRAIL scale, to allow physicians to objectively recognize frail persons. 4. For the purposes of optimally managing individuals with physical frailty, all persons older than 70 years and all individuals with significant weight loss (>5%) due to chronic disease should be screened for frailty., (Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.)

Objectives: Beyond the well-known effect of educational level on cognitive performances, the present study investigates the specific effect of literacy acquisition independently of education., Design: A sample of 175 unschooled elderly participants was selected from a larger Mexican population-based cohort study., Participants: The sample of 175 subjects who never went to school was divided in two groups: 109 who never acquired literacy skills and 66 who declared having acquired reading and writing abilities., Measurements: Cognitive performances on commonly used tests (mini mental state examination, Isaacs set test, free and cued selective reminding test and clock-drawing test) were compared between the two groups taking into account several potentially confounding factors., Results: The participants with reading and writing skills performed better than their counterparts in most tests, even though no difference was observed for the Isaacs Set Test and the delayed recall of the free and cued selective reminding test., Conclusion: Writing and reading skills in elderly people with no formal education influence performances in very commonly used test. Not only educational level but also literacy acquisition should be taken into account when conducting cognitive assessment in very low educated elderly people.

Objective: To determine the association of the five frailty criteria from the Cardiovascular Health Study, as well as cognitive impairment, with prevalent disability for the instrumental (IADL) and basic activities of daily living (ADL)., Design: Cross-sectional study of 475 community-dwelling subjects aged 70 and older, participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty., Measurements: Six probable frailty criteria were considered: weight loss, poor endurance, low physical activity, slowness, weakness, and cognitive impairment. The association of each component of frailty for IADL and ADL disability as main outcomes was determined constructing multivariate logistic regression analyses. Final models were adjusted by socio-demographic factors and the presence of the other five frailty components as covariates., Results: Mean age of participants was 78.1 (SD=6.2). The unadjusted results showed that each of the components of frailty, except weight loss, was associated with both IADL and ADL disability. However, after adjustment, only low physical activity [Odds ratio (OR) =3.27; 95% CI=1.56 to 6.85] and cognitive impairment (OR=2.06; 95% CI=1.04 to 4.06) remain independently associated with IADL disability. Regarding ADL disability, only a lower physical activity (OR=7.72; 95% CI=1.28 to 46.46) was associated with this outcome, whereas cognitive impairment was marginally associated but was not statistically significant (OR=5.45; 95% CI=0.91 to 32.57)., Conclusions: Cognitive impairment and low physical activity are the main contributing factors of frailty phenotype to disability. Better understanding the independent contribution of each frailty subdimension to the different adverse-health outcomes may help to provide a more adequate management of frail elderly.

Aim: To adapt the Quality of Life in Alzheimer's Disease (QOL-AD) scale to Spanish, as well as to evaluate its reliability and validity in Mexico., Subjects and Methods: The study involved a sample of 114 patients diagnosed with Alzheimer, vascular and mixed-type dementia, according to the criteria of the National Institute for Neurological and Communicative Disorders/Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA), the National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) and the Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC), respectively. Their primary caregivers (n = 114) and a control group (n = 30) of persons aged 60 or over without dementia and their closest relatives were also evaluated., Results: The total group with dementia obtained a mean age and a standard deviation of 80.15 +/- 7.13. The Folstein minimental test was 18.55 +/- 4.99. We obtained a Cronbach's alpha of 0.88 for the patient version of the QOL-AD (QOL-ADp) and 0.82 for the caregiver version of the QOL-AD (QOL-ADc). The test-retest yielded an intraclass correlation coefficient of 0.9 (p < 0.001; 95% confidence interval, CI 95% = 0.58-0.91) for the QOL-ADp and 0.81 (p < 0.001; CI 95% = 0.78-0.95) for the QOL-ADc. Moreover, the QOL-ADp showed a significant correlation with the geriatric depression scale (r = -0.73; p < 0.001) and with the neuropsychiatric inventory (r = -0.44; p < 0.001). With the QOL-ADc, these correlations were r = -0.5 (p < 0.001) and r = -0.3 (p < 0.001), respectively. Both versions of the QOL-AD were able to distinguish between the group of subjects with dementia and the control group., Conclusions: The QOL-AD yielded satisfactory results in terms of internal and external reliability, validity between measurements and between known groups. Thus, we can recommend its use to evaluate the quality of life of patients with dementia.

The objective of this comparative cross-sectional study was to determine the prevalence of dyslipidemias and examine its association with food intake and metabolic variables in urban and rural elder Mexican populations. Three different communities (urban areas of medium and low income and a rural area) were studied. A total of 344 subjects aged 60 years and older and 273 aged 35 to 59 years were included. The evaluated parameters were personal medical data, 24-hour diet recall, and fasting plasma lipids, insulin, and glucose levels. Older subjects, especially men, living in the rural area had lower cholesterol levels (5.02 +/- 0.97 v 5.6 +/- 1.07 mmol/L; P <.05) and insulin levels (12 +/- 10 v 42 +/- 68 mU/mL) and higher high-density lipoprotein cholesterol concentrations (1.31 +/- 0.36 v 1.07 +/-0.28 mmol/L) than the elders from the urban medium-income group. Possible explanations for these differences are found in the dietary habits of the groups. Rural elders had higher amounts of fiber (20 +/- 11 v 10 +/- 6 g/d) and carbohydrate (70% +/- 0.08% v 52% +/- 0.11% of calories) and lower fat (18% +/- 0.07% v 33% +/- 0.1% of calories) in their diets. In the urban groups, low-density lipoprotein hypercholesterolemia was present in 17.8% of adult and 39.1% of elderly women (P =.00001). In conclusion, environmental factors still play a prominent role in the pathophysiology of the dyslipidemias in the elderly., (Copyright 2001 by W.B. Saunders Company)

Objective: To determine the prevalence of obesity and its association to different variables in urban and rural older Mexican populations., Methods and Procedures: A cross-sectional study of three different Mexican communities. A total of 121 men and 223 women 60 years and older and 93 men and 180 women aged 35 to 59 years old were selected randomly for inclusion in the survey. A personal interview assessed demographic information, personal medical history and functional status and a 24-hour diet recall was obtained. The physical examination included anthropometric and blood pressure measurements. A fasting blood sample was obtained for measurements of lipids, insulin and glucose., Results: Obesity was highly prevalent in women, in individuals from the urban communities and diminished with advancing age. A BMI > or =30 kg/m2 was observed in 23.6% younger vs. 15.6% older adult men (p=0.21) and 28.4% younger vs. 19.7% older adult women (p = 0.06). The association of obesity with other variables was estimated using a stepwise multivariate logistic regression, increased insulin levels [Odds Ratio (OR) 1.68, p=0.006] and living in an urban area (OR 5.90, p<0.007) were variables independently associated to obesity in adult older individuals. In the younger adults, obesity was associated with hypertension (OR 2.74, p<0.0009), higher insulin levels (OR 1.31, p<0.03) and central adiposity (OR 2.97, p = 0.05), these relationship were not observed with gender, distribution of food or alcohol intake or other coronary risk factors., Conclusions: The present survey confirms the high prevalence of obesity in the Mexican urban population that declines with advanced age. Studies in elderly population must consider the bias produced by increased early mortality in those individuals with a more unfavorable risk profile.

Objective: To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations., Design: A cross-sectional study., Setting: Three Mexican communities (urban areas of medium and low income and a rural area)., Participants: A total of 121 men and 223 women aged 60 years and older and 93 men and 180 women aged 35 to 59 years were selected randomly for inclusion in the survey, which was derived from the CRONOS study (Cross-Cultural Research on Nutrition in the Older Adult Study Group) promoted by the European Economic Community., Measurements: A personal interview assessed demographic information, personal medical history, and functional status, and a 24-hour diet recall was obtained. A physical examination included anthropometric and blood pressure measurements. A fasting blood sample was obtained for measurements of lipids, insulin, and glucose., Results: Diabetes prevalence was higher in men than in women for all age groups: 16.7% versus 9.5% in younger adults and 30.8% versus 22.8% in older adults. For all age groups, diabetes was more highly prevalent in urban communities. Using a multivariate stepwise logistic regression, variables associated independently with diabetes in older individuals were: gender (male sex: OR = 2.1; P < .009); diminished carbohydrate intake in the diet (OR = 0.77; P < .03); central distribution of adiposity (OR = 1.9; P < .03); and functional disability (OR = 2.3; P < .01). This relationship was not observed with living area, income, education, fiber and alcohol intake, body mass index, or age. Individuals 80 years and older had a diminished atherogenic risk profile. Diabetes in older people was associated significantly with hypertriglyceridemia, impaired functional status, and an increased prevalence of ischemic heart disease; in younger adults diabetes was associated with low density lipoprotein (LDL) hypercholesterolemia, hypertriglyceridemia, and a proportionally higher fat intake., Conclusion: This survey confirms the high prevalence of diabetes in the older Mexican population - particularly in men and in individuals living in urban areas - associated with an increased prevalence of other coronary risk factors. Diabetes was associated with higher fat, low carbohydrate, low fiber diets and increased prevalence of central distribution of adiposity. In the older subjects, diabetes was associated significantly with hypertriglyceridemia, impaired functional status, and increased prevalence of ischemic heart disease. A bias produced by early mortality and a survivorship effect must be considered in studies of older individuals. The health situation in the older Mexican population presents a complex problem that needs correct diagnosis and better strategies to benefit those segments of the population at increased risk.