Motivo de consulta, signos y síntomas en adultos mayores en la consulta ambulatoria especializada en Geriatría.
[Motivo de consulta, signos y síntomas en adultos mayores en la consulta ambulatoria especializada en Geriatría.]Luis Manuel Cornejo Alemán1
1. Facultad de Medicina Universidad de Panamá.
Descargas
Resumen
Resumen. Para determinar los motivos de consulta, la frecuenciade patologías, síntomas y estilos devida se realizó una investigación retrospectiva de los expedientes de 633pacientes mayores de 60 años de primera consulta de geriatría en atenciónprivada, en los Consultorios Médicos Paitilla. Los resultados demostraron que los motivos de consultamás frecuentes fueron el chequeo general, (23.5%), la preocupación por pérdidade la memoria (8.3%) y síntomas de depresión (4.8%). Las patologías másfrecuentes fueron la hipertensión (26.4%), Dislipidemia (22.1%) y Diabetes Mellitus (14.8%).Los síntomas más frecuentes fueron trastornos de la memoria (37%), desánimo (37.4%)y trastornos del sueño (31.8%).En estilos de vida encontramos un promedio de 3.2±1.93 medicamentos por paciente y una baja frecuencia de ejercicio regular (18.5%). Los datos obtenidos permiten conocer mejor lasnecesidades asistenciales de las personas adultas mayores, orientando y lapromoción de la Salud y la prevención de la enfermedad en este grupo de edad.
Palabras Clave: Geriatría; adultomayor; motivo de consulta; atención ambulatoria; comorbilidad.
__________________________________________________________________
Abstract
To analize the chief complaints, the frequency of diseases, symptoms and lifestyles, we made a retrospective study of 633 records of patients with more than 60 years old in their first consultation at an outpatient geriatric particular office in Consultorios Médicos Paitilla. The results showed that the most frequent reasons for consultation were a general medical evaluation, (23.5%), loss of memory (8.3%) and symptoms of depression (4.8%). The most frequent diseases were hypertension (26.4%), dislipidemia (22.1%) and Diabetes Mellitus (14.8%). The most frequent symptoms were memory impairement (37%), depression (37.4%) and sleep disorders (31.8%). In their life styles we found an average of 3.2+-1.9 use of drugs per patient and a low frequency of regular exercise (18.5%). The acquired data allows a better knowledge of the care needed in older people, guiding the preventive and educational programs on health promotion for new researches about elderly ambulatory care.
Keywords: geriatrics, elderly outpatient care, symptoms and signs, chief complaints, comorbidity.
Complaint, signs and symptoms in older adults in the outpatient clinic specializing in geriatrics.
Abstract
To analyze the chief complaints, the frequency of diseases, symptoms and lifestyles, we made a retrospective study of 633 records of patients with more than 60 years old in their first consultation at an outpatient geriatric particular office in Consultorios Medicos Paitilla. The results showed that the most frequent reasons for consultation were a general medical evaluation, (23.5%), loss of memory (8.3%) and symptoms of depression (4.8%). The most frequent diseases were hypertension (26.4%), Dislipidemia (22.1%) and Diabetes Mellitus (14.8%). The most frequent symptoms were memory impairment (37%), depression (37.4%) and sleep disorders (31.8%). In their life styles we found an average of 3.2 +-1.9 uses of drugs per patient and a low frequency of regular exercise (18.5%). The acquired data allows a better knowledge of the care needed in older people, guiding the preventive and educational programs on health promotion for new researches about elderly ambulatory care.
Keywords: geriatrics, elderly outpatient care, symptoms and signs, chief complaints, co morbidity.
Abstract
Resumen. Para determinar los motivos de consulta, la frecuenciade patologías, síntomas y estilos devida se realizó una investigación retrospectiva de los expedientes de 633pacientes mayores de 60 años de primera consulta de geriatría en atenciónprivada, en los Consultorios Médicos Paitilla. Los resultados demostraron que los motivos de consultamás frecuentes fueron el chequeo general, (23.5%), la preocupación por pérdidade la memoria (8.3%) y síntomas de depresión (4.8%). Las patologías másfrecuentes fueron la hipertensión (26.4%), Dislipidemia (22.1%) y Diabetes Mellitus (14.8%).Los síntomas más frecuentes fueron trastornos de la memoria (37%), desánimo (37.4%)y trastornos del sueño (31.8%).En estilos de vida encontramos un promedio de 3.2±1.93 medicamentos por paciente y una baja frecuencia de ejercicio regular (18.5%). Los datos obtenidos permiten conocer mejor lasnecesidades asistenciales de las personas adultas mayores, orientando y lapromoción de la Salud y la prevención de la enfermedad en este grupo de edad.
Palabras Clave: Geriatría; adultomayor; motivo de consulta; atención ambulatoria; comorbilidad.
__________________________________________________________________
Abstract
To analize the chief complaints, the frequency of diseases, symptoms and lifestyles, we made a retrospective study of 633 records of patients with more than 60 years old in their first consultation at an outpatient geriatric particular office in Consultorios Médicos Paitilla. The results showed that the most frequent reasons for consultation were a general medical evaluation, (23.5%), loss of memory (8.3%) and symptoms of depression (4.8%). The most frequent diseases were hypertension (26.4%), dislipidemia (22.1%) and Diabetes Mellitus (14.8%). The most frequent symptoms were memory impairement (37%), depression (37.4%) and sleep disorders (31.8%). In their life styles we found an average of 3.2+-1.9 use of drugs per patient and a low frequency of regular exercise (18.5%). The acquired data allows a better knowledge of the care needed in older people, guiding the preventive and educational programs on health promotion for new researches about elderly ambulatory care.
Keywords: geriatrics, elderly outpatient care, symptoms and signs, chief complaints, comorbidity.
Complaint, signs and symptoms in older adults in the outpatient clinic specializing in geriatrics.
Abstract
To analyze the chief complaints, the frequency of diseases, symptoms and lifestyles, we made a retrospective study of 633 records of patients with more than 60 years old in their first consultation at an outpatient geriatric particular office in Consultorios Medicos Paitilla. The results showed that the most frequent reasons for consultation were a general medical evaluation, (23.5%), loss of memory (8.3%) and symptoms of depression (4.8%). The most frequent diseases were hypertension (26.4%), Dislipidemia (22.1%) and Diabetes Mellitus (14.8%). The most frequent symptoms were memory impairment (37%), depression (37.4%) and sleep disorders (31.8%). In their life styles we found an average of 3.2 +-1.9 uses of drugs per patient and a low frequency of regular exercise (18.5%). The acquired data allows a better knowledge of the care needed in older people, guiding the preventive and educational programs on health promotion for new researches about elderly ambulatory care.
Keywords: geriatrics, elderly outpatient care, symptoms and signs, chief complaints, co morbidity.
Citas
[2] Contraloría General de la República, Dirección de Estadística y Censo; Estadísticas Nacionales. http://www.contraloria.gob.pa/inec/, accesado en agosto, 2012.
[3] Steinbrook R. Patients with multiple chronic conditions-how many medications are enough? N. Engl J Med 1998; 338: 1541-1542.
[4] Duursma S, Castleden M, Cherubini A, Cruz Jentoff A, Pitkala K, et al. European Union Geriatric Medicine Society. Position statement on geriatric medicine and the provision of health care services to older people. J. Nutr.Health Aging 2004; 8 (3) 190-5.
[5] Cornejo Luis. Prevalencia de Morbidade Clínica em pacientes maiores de 60 años. Tesis de grado de Maestría, Pontificia Universidad Católica do Rio Grande do Sul, 1992, Porto Alegre, Brasil.
[6] Howell T, Piggot A. Morbid Anatomy of old Age. Geriatrics, 1951 6(2); 85-95.
[7] Emmett KR. Nonspecific and atypical presentation of disease in the older patient. Geriatrics 1998; 53 (2): 50-52. 58-60.
[8] Kroenke K. Studying Symptoms: Sampling and Measurement Issues. Ann. Intern. Med. 2001, 134 (9 Pt2); 844-853.
[9] Schubert C, Boustani M, Callahan C, Perkins A, Carney CP, et al. Comorbidity Profile of Dementia Patients in Primary Care: Are They Sicker? J Am Geriatr Soc 2006, 54 (1): 104-109.
[10] Landefeld CS. Improving Health Care for Older Persons. Ann Intern Med 2003;
[11] Di Bari M, Virgillo A, Mateuzzi D, Inzitari M, Mazzaglia G, Pozzi C, et al. Predicitive validity of measures of comorbidity in older community dwellers: the insufficienza cardiaca negli anziani residenti a Dicomano Study. J.Am.Geriatr.Soc.2006 54(2): 210-16.
[12] Chobanian A, Bakris G, Black H, Cushman W, Green L, et al. The National High Blood Pressure Education Program Coordinating Committee. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension 2003 (42)1206-1252.
[13] Wolff Jl, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch. Intern Med 2002; 162(20): 2269-2276.
[14] Karlamangla A., Tinetti M., Guralnik J., Studenski S, Wetle T, Reuben D. Comorbidity in Older Adults: Nosology of Impairment, Diseases, and Conditions. J. Gerontol A Biol Sci Med Sci 2007, 62 (3):296-300.
[15] Roriz-Cruz M., Rosset I., Roriz-filho J.,Cruz TR, Morais EP, et al. Medical Complaints and Psychosocial and cultural characteristics of a Nationwide Sample of 2,136 Community-Dwelling Brazilian Elderly People: The Fundacao Perseu Abramo Project. J Am. Geriatr Soc. 2008, 56 (4) 762-764.
[16] Picarscic Jl, Glinn NW, Taylor CA., Katula JA, Goldman SE, et al. Self-reported napping and duration and quality of sleep in the lifestyle interventions and independence for elders pilot study. J. Am. Geriatr. Soc.2008; 56(9): 1674-80.
[17] Bernal de Mas, Mabel. Estudio sobre el estado nutricional y calidad de vida del adulto mayor que asiste a consulta en Centros de Salud y Policlínicas de San Miguelito y Área Metropolitana. Publicación del Ministerio de Salud S/N, República de Panamá, 2003.
[18] U.S. Department of Health and Human Services: Centers for Disease Control and Prevention. Healthy aging. http://www.cdc.gov/chronicdisease/resources/publications/aag/aging.htm. Who's Certified [Internet]. Evanston (IL): The American Board of Medical Specialists. c2000 - [cited 2001 Mar 8]. Available from: http://www.abms.org/newsearch.asp.
[19] Moreno de Rivera A, Roa R, Mc Donald A, Luque H, González B, Gómez B. Encuesta Nacional de Salud y Calidad de Vida, 2007.Publicación del Instituto Conmemorativo Gorgas de Estudios de la Salud y el Ministerio de Salud, S/N, República de Panamá, 2009.
[20] Lima-Costa MF, Barreto SM, Uchoa E, Firmo JO, Vidigal PG. The Bambuí Health and Aging study (BHAS): prevalence of risk factors and use of preventive health care services. Rev Pan Salud Pública, 2001, 9 (4), 2001; 219-227.
[21] Di Trolio Julio, Alfano Adriana. Evaluación del estado de salud de pacientes ambulatorios mayores de 65 años. Resumen. II Congreso del Comité Regional Latinoamericano y VII Congreso Argentino de Gerontología y Geriatría. Vivir en Plenitud, 1997, 38; 20-21.
[22] Encuesta Multicéntrica, Salud y Bienestar y envejecimiento (SABE) en América Latina y el Caribe. Organización Panamericana de la Salud, , Washington, 2001, CAIS36/2001.5
[23] Vargas CM, Burt VL, Guillum RF. Cardiovascular Disease in the NHANES III. Ann Epidemiol 1997; 7(8): 523-5.
[24] Anraku A., Jin YP, Butty Z., Jinapriya D, Alasbali T,et al. The Toronto Epidemiology Glaucoma Survey: a pilot study. Can J, Ophthalmol. 2011, 46 (4)352-7.
[25] Rozenfeld S., Camacho L., Veras P. Medication as a risk factor for falls in older women in Brazil. Rev. Panam Salud Pública 2003, 13(6), 369-375.
[26] Pitt SW, Byles JE, Cockburn J. Medication Review: patient selection and general practitioner’s report of drug-related problems and action taken in elderly Australians. J. Am Geriatr Soc. 2007 55(6): 927-934.
[27] Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: The Slone survey. JAMA 2002; 287(3):337-344.
[28] De la Calzada MD. Modificaciones del sueño en el envejecimiento. Rev Neurol 2000; 30(6): 577-580.
[29] Lee P., Cigolle C., Blaum C. The Co-Occurrence of Chronic Diseases and Geriatric Syndromes: The Health and Retirement Study. J. Am Geriatr Soc.2009, 57(3): 511-516.
[30] Smith A., Wang PC, Anger JT, Mangioni CM, Trejo L, et al. Correlates of Urinary Incontinence in Community-Dwelling Older Latinos. J. Am Geriatr Soc 2010, 58 (6); 1170-1176.
Licencia
Derechos autoriales y de reproducibilidad. La Revista Médica de Panama es un ente académico, sin fines de lucro, que forma parte de la Academia Panameña de Medicina y Cirugía. Sus publicaciones son de tipo acceso gratuito de su contenido para uso individual y académico, sin restricción. Los derechos autoriales de cada artículo son retenidos por sus autores. Al Publicar en la Revista, el autor otorga Licencia permanente, exclusiva, e irrevocable a la Sociedad para la edición del manuscrito, y otorga a la empresa editorial, Infomedic International Licencia de uso de distribución, indexación y comercial exclusiva, permanente e irrevocable de su contenido y para la generación de productos y servicios derivados del mismo. En caso que el autor obtenga la licencia CC BY, el artículo y sus derivados son de libre acceso y distribución.
