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Presentación de PowerPoint - Aula Virtual Regional. Campus Virtual
Epidemiology of aging: A
new vision for managers
Why managers should use epidemiology of
aging?
MSPAS Gabriela Ríos Cázares
Epidemiology
• Describe pattern of disease, risk factors, establish
causality
• Described by time, place and person
• At the beginning, focused on infectious disease, after,
determinants about them, and now to a wide different
kind of variables: genetic, social determinants, mental,
inverse epidemiology
Epidemiology and Public Health
• Provide scientific information to make Public
Health decisions
• Evaluate interventions, projects, programs
• Generate evidence
Epidemiology of aging
• It is the epidemiological study about aging process and its
determinants.
• Because of “the emerging significance of the public health
issues associated with the aging of the population”
• What is the meaning of aging of the population?
▫ Growth:
 Proportional to other ages groups HAM
 Absolut total old persons (60-65)
▫ Emerging significance:
 Knowledge needed: Factors as the mental and/or physical
functionality level, independence, gender, social network, health
and social needs, cultural meanings, community characteristics
and the life course make differences in the way we get old
• Aging process is a different process than disease
process
Aging index
Aging index
2037 Regional Median:
100/100=1/1
http://public.tableausoftware.com/views
/EnvSal_IndiceEnvejecimiento_viz1/Das
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• Life expectancy
• Life expectancy in health
• Premature deaths (NCD)
Aging…
•
•
•
•
Aging process
Life course approach
Active aging
Well-being
Social determinants
• http://www.thelancet.com/journals/lancet/article/PIIS0140673612616900
/images?imageId=gr1&sectionType=red&hasDownloadImagesLink=true
Life course approach
Determinants of Active aging
Well-being
Social
determinants
• A lot of variables to know, to use, to define…
Outcomes…
• Differences about:
▫
▫
▫
▫
▫
▫
▫
Education
Socioeconomic level
Acces to health and social services
Recreation services
Development oportunities
Quality of life
Level of health, but WELL-BEING
• The last expresion of the process is aging
Where is the information?
International surveys
National surveys
Local surveys
Local health and social statistics
(specific or not about old people)
Papers: meta-analysis, review articles
Aging indicators:
•
•
•
•
•
•
•
Functionality
Dependence
Frailty
Falls*
Perception of QoL*
Life satisfaction*
Social network (enough, effective, efficient,
perceived as kindly)
• Feel safe in their community
México, just an example
Distribución de años de vida perdidos por
causa, 2008
100
Porcentaje
61
59
50
19
0
21
20
Trasmisibles
No trasmisibles
Causa
Fuente: OMS, 2008
20
Lesiones
México
Promedio regional
Factores de riesgo en adultos
Hiperglicemia
(mayores de 25 años), 2008
Hombres
Tensión arterial alta
(mayores de 25 años), 2008
Mujeres
Hombres
Mujeres
Obesidad
(mayores de 20 años), 2008
Hombres
Tabaquismo
(mayores de 15 años), 2009
Mujeres
Hombres
Mujeres
100
50
38.4
27.4
26.7
26.3
21.5
13.2
14.9
11.5
24
19.7
26
19.7
16
13.5
9.9
8
0
México
Fuente: OMS, 2008
Promedio regional
Prevalencia de síndromes geriátricos en población
mexicana de 60 y +
70%
65%
62%
60%
50%
47%
46%
42%
40%
40%
37%
36%
60 a 69
32%
31%
30%
25%
20%
20%
10%
0%
Déficit auditivo
Déficit visual
Caídas
Anorexia
70 a 79
80 y más
Distribución porcentual del IMC1 en adultos mayores comparando
criterios de la OMS2 y de Mendoza, et al3 por décadas de edad,
ENSANUT 2012
60-69
45.0
70-79
80 y más
42.5
42.4
39.0
40.0
39.0
33.8
35.0
34.5
29.3
28.3
30.0
28.3
25.0
20.1
20.0
15.7
15.0
11.8
10.0
5.0
6.9
1.1
1.4
3.2
1.6
3.3
0.0
Bajo Peso
Sobrepeso
Criterio OMS
Obesidad
Bajo Peso
Sobrepeso
Obesidad
Ajuste Mendoza, et al
Clasificación de IMC: Desnutrición (<18.5 kg/m2), IMC normal (18.5 a 24.9 kg/m2), sobrepeso (25.0 a 29.9 kg/m2), y obesidad (≥30.0 kg/m2).
World Health Organization. Obesity: Preventing and Managing the Global Epidemic, Report of a WHO Consultation on Obesity, 2000.
3Mendoza-Núñez VM, Sánchez-Rodríguez MA, Cervantes Sandoval A. Equations for predicting height for elderly Mexican-Americans are not
applicable for elderly Mexicans. Am J Human Biol 2002;14:351-55.
Fuente: ENSANUT, 2012
1
2
La sarcopenia ocurre comunmente
con la edad avanzada y acompaña
casi sistemáticamente a la obesidad en estas edades
Promedio de pérdida de masa muscular con la edad
Porcentaje de masa muscular
100%
Por década de 40 a 70 años
90%
8%
pérdida
80%
Por década después de los 70 años
70%
pérdida15%
60%
50%
40%
Edad
Grimby G, Saltin B. Clin Physiol. 1983;3:20.
Janssen I. J Appl Physiol. 2000;89:81
25
40
70
80
Prevalencia de masa muscular baja (sarcopenia) en adultos
mayores por quinquenios de edad, ENSANUT 2012
Masa Muscular Baja
Masa Muscular Alta
100.0
90.0
86.5
83.2
77.9
80.0
73.4
72.9
70.0
60.7
60.0
60.5
50.0
39.3
40.0
30.0
20.0
16.8
22.1
39.5
56.7
43.3
27.1
26.6
13.5
10.0
0.0
60-64
65-69
70-74
75-79
80-84
85-89
90-120
Total
*World Health Organitation. Uses and interpretation of anthropometry in the elderly for the assessment of physical status. Interim draft report of
nutrition unit. Ginebra: WHO,The Subcommitteeon the elderly, 1992.
Fuente: ENSANUT, 2012
Probabilidad de desarrollar discapacidad en
Probabilidad de desarrollar discapacidad
presencia
de multimorbilidad específica
en presencia de multi-morbilidad específica
78.21%
26.72%
Sin ECNT
34.29%
38.19%
DM
DM + otra
ECNT
ECNT: enfermedad crónica no transmisible
DM: Diabetes mellitus
43.41%
DM + ECNT + 1 DM + ECNT +
déficit sensorial
2 déficit
Fuente: ENSANUT, 2012
Disability
• 2000: the most serious discapacity was on 15-44
population
• 2050: 4-5 fold in some american countries
• 7/10 elderly receive family care
• http://www.who.int/gho/ncd/en/index.html
Evidence Based Decisions
DIAGNOSIS
PLAN
(S,T,O)
EVIDENCE
OBJECTIVESACTIVITIESTARGETSEVALUATION
EVALUATION
COST/FIN
ANCIAL
RESOURC
ES
CONTROL/
SUPERVIT
ION
IMPLEME
NTATION
You are not alone
• Inter,, multi, transdisciplinary…
▫ teams, approaches, decisions, interventions,
evaluations
• Knowledge management: data ----- information ---knowledge
• Define goals in senior interventions, programs,
projects. Specific and Intersectorial proposals
The best answer we can
build to our aging
population
Resources
http://www.who.int/ageing/publications/lifecourse/en/
http://www.paho.org
http://www.healthyolderpersons.org/
http://ais.paho.org
http://www.cdc.gov/aging/
http://www.who.int/healthinfo/sage/en/
http://www.agewatch.org.uk/
THANK YOU
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