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ASPECTOS DIFERENCIALES ANCIANOS PLURIPATOLÓGICOS      NICOLÁS MARTÍNEZ VELILLA COMPLEJO HOSPITALARIO DE NAVARRA
COMORBILIDAD
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MULTIMORBILIDAD: Múltiples enfermedades en un individuo
IMPACTO MORBILIDAD: Impacto global de la suma de enfermedades + gravedad
COMPLEJIDAD: Impacto global de las diferentes enfermedades en individuo; gravedad de enfermedades – otros aspectos relacionados con la saludNo todos los Ancianos son PluripatológicosLa mayoría de Pluripatológicos son Ancianos
PREVALENCIA MULTIMORBILIDAD
Impact of multi-morbidity on physical limitations Kriegsman et al. Disability Rehabilitation 1997;19:71-83
Impact of multimorbidity on 3-year decline in physical functioning Kriegsman et al. J Clin Epidemiol 2004;57:55-65
Multimorbidity and depressive symptoms Penninx et al. J Psychosom Res 1996;40:521-534; Adapted from Kriegsman D, NIA Comorbidity Conference, 2005
Impact of multimorbidity on 3-year mortality Kriegsman & Deeg. In: Autonomy and well-being in the aging population 2 (1997)
Impact of Multimorbidity on Hospitalization: Hospitalization for Ambulatory Care Sensitive Condition by Number of Chronic Conditions Wolff, J. NIA Comorbidity Conference, 2005
Most people with any long term condition have multiple conditions in Scotland
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Comorbilidad como factor de confusión
Exclusión sistemática de los ensayos
Paciente tipo de ensayos no es nuestro paciente habitual
Arch Intern Med. 2011 Mar 28;171(6):550-6. The persistent exclusion of older patients from ongoing clinical trials regarding heart failure. Despite the recommendations of national and international regulatory agencies, exclusion of older individuals from ongoing trials regarding heart failure continues to be widespreadCOMORBILIDAD Y ENSAYOS CLÍNICOS
EPOC Heart failure and chronic obstructive pulmonary disease: Two for tea or tea for two? World J Cardiol. 2010 October 26; 2(10): 305–307. Respir Care. 2011 May;56(5):644-52. Epub 2011 Jan 27.Anemia in COPD: a systematic review of the prevalence, quality of life, and mortality. Chronic respiratory disease and multimorbidity: Prevalence and impact in a general practice setting. Respir Med. 2011 Feb;105(2):236-42. Lung. 2010 Aug;188(4):321-9. Comorbidity, hospitalization, and mortality in COPD: results from a longitudinal study. Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities. The Proceedings of the American Thoracic Society 5:848-856 (2008) J Card Fail. 2010 Mar;16(3):225-9. COPD predicts mortality in HF: the Norwegian Heart Failure Registry.
FRAGILIDAD / COMORBILIDAD COGNICIÓN SARCOPENIA DETERIORO FUNCIONAL INFLAMACIÓN COMPLEJIDAD DE LAS INTERACCIONES ANEMIA
CONSECUENCIAS DE LA ANEMIA DETERIORO FUNCIONAL MORTALIDAD INGRESOS  HOSPITALARIOS ANEMIA DETERIORO COGNITIVO CALIDAD DE VIDA EMPEORAMIENTO DE  COMORBILIDAD
DIABETES Diabetes Res Clin Pract. 2011 Jan;91(1):115-20. The association between co-morbidity and the use of antidiabetics or adjunctive cardiovascular medicines in Australian veterans with diabetes.  PLoS One. 2010 Nov 17;5(11):e14024. Influence of comorbidities on therapeutic progression of diabetes treatment in Australian veterans: a cohort study. Diabet Med. 2010 Jan;27(1):65-71. Co-morbidity and the utilization of health care for Australian veterans with diabetes. Endocr Pract. 2011 Sep 22:1-16. The Effect of Metformin Therapy on Vitamin D and B12 Levels in Patients with Diabetes Mellitus Type 2. Lancet. 2011 Jul 9;378(9786):129-39. Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial. .Cardiovasc Diabetol. 2011 May 21;10:43.Therapeutic potential of N-acetylcysteine as an antiplatelet agent in patients with type-2 diabetes. Diabetes Res Clin Pract. 2010 Mar;87(3):385-93.  Comorbidity in the elderly with diabetes: Identification of areas of potential treatment conflicts.
OSTEOPOROSIS Y DM World J Diabetes. 2011 Mar 15;2(3):41-8. Osteoporosis in diabetes mellitus: Possible cellular and molecular mechanisms.
DEPRESIÓN ,[object Object]
J Gen Intern Med. 2011 Oct;26(10):1175-82. Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis.
Gen Hosp Psychiatry. 2011 May-Jun;33(3):217-23. Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression.
Arch Intern Med. 2011 Sep 26;171(17):1571-8. Coffee, caffeine, and risk of depression among women.
J Clin Psychiatry. 2011 Apr;72(4):529-38. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials.
Lancet. 2011 Jul 30;378(9789):403-11. Sertraline or mirtazapine for depression in dementia (HTA-SADD): a randomised, multicentre, double-blind, placebo-controlled trial.
Arch Intern Med. 2010 Nov 22;170(21):1884-91. Bidirectional association between depression and type 2 diabetes mellitus in women.,[object Object]
Arch Intern Med. 2008 Nov 10;168(20):2232-7. Antidepressant use, depression, and survival in patients with heart failure.
Stroke. 2011 Aug 25. Increased Frequency of First-Episode Poststroke Depression After Discontinuation of Escitalopram.
J Card Fail. 2011 Sep;17(9):748-54. Effects of sertraline on circulating markers of oxidative stress in depressed patients with chronic heart failure: a pilot study
Diabetes Care. 2011 Sep 12. Elevated Depressive Symptoms, Antidepressant Use, and Diabetes in a Large Multiethnic National Sample of Postmenopausal Women.

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Presentación orue 2011 nicolas martinez slideshare

  • 1. ASPECTOS DIFERENCIALES ANCIANOS PLURIPATOLÓGICOS NICOLÁS MARTÍNEZ VELILLA COMPLEJO HOSPITALARIO DE NAVARRA
  • 3.
  • 4.
  • 5.
  • 7. IMPACTO MORBILIDAD: Impacto global de la suma de enfermedades + gravedad
  • 8. COMPLEJIDAD: Impacto global de las diferentes enfermedades en individuo; gravedad de enfermedades – otros aspectos relacionados con la saludNo todos los Ancianos son PluripatológicosLa mayoría de Pluripatológicos son Ancianos
  • 9.
  • 11.
  • 12.
  • 13. Impact of multi-morbidity on physical limitations Kriegsman et al. Disability Rehabilitation 1997;19:71-83
  • 14. Impact of multimorbidity on 3-year decline in physical functioning Kriegsman et al. J Clin Epidemiol 2004;57:55-65
  • 15. Multimorbidity and depressive symptoms Penninx et al. J Psychosom Res 1996;40:521-534; Adapted from Kriegsman D, NIA Comorbidity Conference, 2005
  • 16. Impact of multimorbidity on 3-year mortality Kriegsman & Deeg. In: Autonomy and well-being in the aging population 2 (1997)
  • 17.
  • 18. Impact of Multimorbidity on Hospitalization: Hospitalization for Ambulatory Care Sensitive Condition by Number of Chronic Conditions Wolff, J. NIA Comorbidity Conference, 2005
  • 19.
  • 20. Most people with any long term condition have multiple conditions in Scotland
  • 21.
  • 22.
  • 23.
  • 24. Comorbilidad como factor de confusión
  • 26. Paciente tipo de ensayos no es nuestro paciente habitual
  • 27. Arch Intern Med. 2011 Mar 28;171(6):550-6. The persistent exclusion of older patients from ongoing clinical trials regarding heart failure. Despite the recommendations of national and international regulatory agencies, exclusion of older individuals from ongoing trials regarding heart failure continues to be widespreadCOMORBILIDAD Y ENSAYOS CLÍNICOS
  • 28.
  • 29. EPOC Heart failure and chronic obstructive pulmonary disease: Two for tea or tea for two? World J Cardiol. 2010 October 26; 2(10): 305–307. Respir Care. 2011 May;56(5):644-52. Epub 2011 Jan 27.Anemia in COPD: a systematic review of the prevalence, quality of life, and mortality. Chronic respiratory disease and multimorbidity: Prevalence and impact in a general practice setting. Respir Med. 2011 Feb;105(2):236-42. Lung. 2010 Aug;188(4):321-9. Comorbidity, hospitalization, and mortality in COPD: results from a longitudinal study. Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities. The Proceedings of the American Thoracic Society 5:848-856 (2008) J Card Fail. 2010 Mar;16(3):225-9. COPD predicts mortality in HF: the Norwegian Heart Failure Registry.
  • 30. FRAGILIDAD / COMORBILIDAD COGNICIÓN SARCOPENIA DETERIORO FUNCIONAL INFLAMACIÓN COMPLEJIDAD DE LAS INTERACCIONES ANEMIA
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