Seguimiento del estado cognoscitivo en ancianos con miedo a caer, sin deterioro cognoscitivo, evaluados en una clínica de inestabilidad, vértigo y caídas

dc.contributorCurcio, Carmen-Lucia
dc.contributorGrupo de Investigación en Gerontología y Geriatría (Categoría A1)
dc.creatorLópez, Sebastián
dc.date2023-03-30T23:29:21Z
dc.date2023-03-30T23:29:21Z
dc.date2023-03-30
dc.date.accessioned2023-09-06T18:26:55Z
dc.date.available2023-09-06T18:26:55Z
dc.identifierhttps://repositorio.ucaldas.edu.co/handle/ucaldas/18883
dc.identifierUniversidad de Caldas
dc.identifierRepositorio Institucional Universidad de Caldas
dc.identifierhttps://repositorio.ucaldas.edu.co/
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8697509
dc.descriptionIlustraciones
dc.descriptionspa:En el presente estudio se realizó un análisis longitudinal de personas mayores de 60 años sin deterioro cognoscitivo inicial, evaluados en la Clínica de Inestabilidad, Vértigo y Caídas de la Universidad de Caldas con el objetivo de evaluar si el miedo a caer (medido por FES-I) era predictor de deterioro cognoscitivo a 6 años. La muestra estuvo conformada por 45 pacientes, ninguno presentó miedo a caer leve por lo que se realizó dicotomización en cuanto a miedo a caer moderado con 11 pacientes (24,4%) y alto con 34 pacientes (75,6%). En el análisis multivariado longitudinal a través de la regresión logística multinomial, el deterioro cognoscitivo fue mayor en los pacientes con miedo a caer alto luego de ajustar por dos modelos de covariables (OR: 2,892, IC 95%: 1,806-3,699). La comparación de los valores del Minimental entre el 2016 y 2022 se encontró asociación significativa en atención y cálculo (Dif: -0,794 DE:2,11, p=0,036) y en el puntaje total (Dif: -4,764, DE:5,48, p=0,000). Se concluye que el miedo a caer alto se asocia significativamente con el deterioro cognoscitivo en personas mayores de 60 años, independiente de presencia de caídas en el último año, grado de dependencia y escolaridad.
dc.descriptioneng:In this study, a longitudinal analysis of people over 60 years of age without initial cognitive impairment, evaluated at the Clinic of Instability, Vertigo and Falls of the University of Caldas, was carried out with the objective of evaluating whether the fear of falling (measured by FES- I) was a predictor of cognitive impairment at 6 years. The sample consisted of 45 patients, none of whom presented a mild fear of falling, so a dichotomization was carried out in terms of moderate fear of falling with 11 patients (24.4%) and high with 34 patients (75.6%). In longitudinal multivariate analysis using multinomial logistic regression, cognitive impairment was greater in patients with fear of falling high after adjusting for two covariate models (OR: 2.892, 95% CI: 1.806-3.699). The comparison of the Minimental values between 2016 and 2022 found a significant association in attention and calculation (Diff: -0.794 SD:2.11, p=0.036) and in the total score (Dif: -4.764, DE:5, 48, p=0.000). It is concluded that the fear of falling high is significantly associated with cognitive impairment in people over 60 years of age, regardless of the presence of falls in the last year, degree of dependency and schooling.
dc.description1. Introducción / 1.1. Marcha y función cognoscitiva / 1.2. Miedo a caer / 1.3. Miedo a caer y alteraciones en la marcha / 1.4. Miedo a caer y deterioro cognoscitivo / 1.5. Problema de investigación / 1.6. Pregunta de investigación / 2. Justificación / 3. Objetivos / 4. Materiales y métodos / 4.1. Enfoque de investigación, diseño y tipo de estudio / 4.2. Muestra / 4.3. Instrumentos / 4.4. Plan de análisis / 4.5. Consideraciones éticas / 5. Resultados / 5.1. Influencia del miedo a caer en el deterioro cognoscitivo y sus variables asociadas / 6. Discusión / 6.1. Fortalezas / 6.2. Limitaciones / 7. Conclusiones y recomendaciones / 7.1. Conclusiones / 7.2. Recomendaciones / 8. Referencias bibliográficas
dc.descriptionEspecialización médico - quirúrgica
dc.descriptionEspecialista Medicina Interna - Geriatría
dc.descriptionEnvejecimiento y vejez
dc.formatapplication/pdf
dc.formatapplication/pdf
dc.formatapplication/pdf
dc.formatapplication/pdf
dc.languageeng
dc.languagespa
dc.publisherFacultad de Ciencias para la Salud
dc.publisherManizales
dc.publisherEspecialización Medicina Interna - Geriatría
dc.relationMinisterio de Salud y Protección Social - Departamento Administrativo de Ciencia Tecnología e Innovación COLCIENCIASU del V y U de C. Encuesta SABE Colombia: Situación de salud, bienestar y envejecimiento en Colombia. Bogotá, D.C. Colombia: PREGRAF IMPRESORES S.A.S.; 2016.
dc.relationDANE. Resultados Censo Nacional de Población y Vivienda. 2018;Tercera entrega.
dc.relationHou Y, Dan X, Babbar M, Wei Y, Hasselbalch SG, Croteau DL, et al. Ageing as a risk factor for neurodegenerative disease. Vol. 15, Nature Reviews Neurology. Nature Publishing Group; 2019. p. 565–81.
dc.relationAmerican Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Arlington; 2013.
dc.relationGrande G, Triolo F, Nuara A, Welmer AK, Fratiglioni L, Vetrano DL. Measuring gait speed to better identify prodromal dementia. Vol. 124, Experimental Gerontology. Elsevier Inc.; 2019.
dc.relationGómez F, Curcio CL. Marcha. In: Salud del anciano: valoración. Blanecolor S.A.S.; 2014. p. 401–17.
dc.relationMorris R, Lord S, Bunce J, Burn D, Rochester L. Gait and cognition: Mapping the global and discrete relationships in ageing and neurodegenerative disease. Neurosci Biobehav Rev. 2016;64:326–45.
dc.relationMartin MP, O’Neill D. Vascular higher-level gait disorders - a step in the right direction? . Lancet. 2004;365(9402):8.
dc.relationZhang W, Low LF, Schwenk M, Mills N, Gwynn JD, Clemson L. Review of Gait, Cognition, and Fall Risks with Implications for Fall Prevention in Older Adults with Dementia. Dement Geriatr Cogn Disord. 2019;48((1-2)):17–29.
dc.relationNutt JG. Classification of gait and balance disorders. Adv Neurol. 2001;87:135–41.
dc.relationHausdorff JM, Yogev G, Springer S, Simon ES, Giladi N. Walking is more like catching than tapping: gait in the elderly as a complex cognitive task. Exp Brain Res. 2005;164(4):541–8.
dc.relationMarquis S, Milar Moore ; M, Howieson DB, Sexton G, Payami H, Kaye JA, et al. Independent Predictors of Cognitive Decline in Healthy Elderly Persons. Arch Neurol [Internet]. 2002;59(4):601–6. Available from: http://archneur.jamanetwork.com/
dc.relationVerghese J, Wang C, Lipton R, Holtzer R, Xue X. Quantitative gait dysfunction and risk of cognitive decline and dementia. J Neurol NeurosurgPsychiatry. 2007;78(9):929–35.
dc.relationMielke MM, Roberts RO, Savica R, Cha R, Drubach DI, Christianson T, et al. Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo Clinic Study of Aging. . J Gerontol A Biol Sci Med Sci. 2013;68(8):929–37.
dc.relationRosso AL, Studenski SA, Chen WG, Aizenstein HJ, Alexander NB, Bennett DA, et al. Aging, the central nervous system, and mobility. J Gerontol A Biol Sci Med Sci. 2013;68(11):1379–86.
dc.relationBonelli RM, Cummings JL. Frontal-subcortical circuitry and behavior. Dialogues Clin Neurosci. 2007;9(2):141–51.
dc.relationAmboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord. 2013;28(11):1520–33.
dc.relationHoltzer R, Epstein N, Mahoney JR, Izzetoglu M, Blumen HM. Neuroimaging of mobility in aging: A targeted review. J GerontolA Biol Sci Med Sci. 2014;69(11):1375–88.
dc.relationHadjistavropoulos T, Delbaere K, Fitzgerald T. Reconceptualizing the role of fear of falling and balance confidence in fall risk. J Aging Health. 2011;23:3–23.
dc.relationWhipple MO, Hamel AV, Talley KMC. Fear of falling among community-dwelling older adults: A scoping review to identify effective evidence-based interventions. Geriatr Nurs. 2018;39(2):170–7.
dc.relationJung D. Fear of falling in older adults: comprehensive review. Asian Nurs Res (Korean Soc Nurs Sci). 2008;2(4):214–22.
dc.relationLitwin H, Erlich B, Dunsky A. The Complex Association Between Fear of Falling and Mobility Limitation in Relation to Late-Life Falls: A SHARE-Based Analysis. J Aging Health. 2018;30(6):987–1008.
dc.relationMurphy J, Isaacs B. The post-fall syndrome. A study of 36 elderly patients. Gerontology. 1982;28(4):265–70.
dc.relationTinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45(6):239–43.
dc.relationMaki BE, Holliday PJ, Topper AK. Fear of Falling and Postural Performance in the Elderly. Journal of Gerontology: MEDICAL SCIENCES [Internet]. 1991;46(4):13. Available from: http://geronj.oxfordjournals.org/
dc.relationTennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A Randomized, Controlled Trial of a Group Intervention To Reduce Fear of Falling and Associated Activity Restriction in Older Adults [Internet]. Vol. 53, Journal of Gerontology: PSYCHOLOGICAL SCIENCES. 1998. Available from: https://academic.oup.com/psychsocgerontology/article/53B/6/P384/618638
dc.relationCurcio C, Gómez J. Factores predictores de temor a caer. Rev Asoc Colomb Gerontol Geriatr. 2006;20(4):959–70.
dc.relationTinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. Journals of Gerontology. 1990;45(6):239-243. 10.1093/geronj/45.6.P239.
dc.relationTinetti ME, Powell L. Fear of falling and low self-efficacy: A cause of dependence in elderly persons. Journals Gerontol. 1994;48:35–8.
dc.relationChang HT CHCP. Fear of falling and mortality among community-dwelling older adults in the Shih-Pai study in Taiwan: A longitudinal follow-up study. Geriatr Gerontol Int. 2017;17(11):2216–23.
dc.relationCurcio CL, Gómez JF. Validez convergente y de constructo de la escala de autoeficacia relacionada con caídas. Rev Asoc Colomb Gerontol Geriatr. 2011;25(4):1558–69.
dc.relationGómez F, Curcio CL. The development of a fear of falling interdisciplinary intervention program. Clin Interv Aging. 2007;2(4):661–7.
dc.relationAuais M, Alvarado BE, Curcio CL, Garcia A, Ylli A, Deshpande N. Fear of falling as a risk factor of mobility disability in older people at five diverse sites of the IMIAS study. Arch Gerontol Geriatr. 2016;66:147–53.
dc.relationCurcio CL, Gómez JF. Temor a caer en ancianos: Controversias en torno a un concepto y a su medición. Hacia la promoción de la salud. 2012;17(2):186–204.
dc.relationAyoubi F, Launay CP, Annweiler C, Beauchet O. Fear of falling and gait variability in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2015;16(1):14–9.
dc.relationMaki BE. Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc. 1997;45(3):313–20.
dc.relationReelick MF, van Iersel MB, Kessels RP, Rikkert MG. The influence of fear of falling on gait and balance in older people. Age Ageing. 2009;38:435–40.
dc.relationRochat S, Büla CJ, Martin E, Seematter-Bagnoud L, Karmaniola A, Aminian K, et al. What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years? Arch Phys Med Rehabil. 2010;91(6):879–84.
dc.relationHausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in communityliving older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82(8):1050–6.
dc.relationShirooka H, Nishiguchi S, Fukutani N, Tashiro Y, Nozaki Y, Hirata H, et al. Cognitive impairment is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int. 2017;17(2):232–8.
dc.relationSakurai R, Suzuki H, Ogawa S, Kawai H, Yoshida H, Hirano H, et al. Fear of falling, but not gait impairment, predicts subjective memory complaints in cognitively intact older adults. Geriatr Gerontol Int. 2017;1125–31.
dc.relationPeeters G, Leahy S, Kennelly S, Kenny RA. Is Fear of Falling Associated With Decline in Global Cognitive Functioning in Older Adults: Findings From the Irish Longitudinal Study on Ageing. J Am Med Dir Assoc. 2018;19(3):248–54.
dc.relationPeeters G, Feeney J, Carey D, Kennelly S, Kenny RA. Fear of falling: A manifestation of executive dysfunction? Int J Geriatr Psychiatry. 2019;1275–82.
dc.relationNoh HM, Roh YK, Song HJ, Park YS. Severe Fear of Falling Is Associated With Cognitive Decline in Older Adults: A 3-Year Prospective Study. J Am Med Dir Assoc. 2019;20(12):1540–7.
dc.relationLangeard A, Desjardins-Crépeau L, Lemay M, Payette MC, Bherer L, Grenier S. Cognitive performances better identify fallers than mobility assessment among older adults with fear of falling. Aging Clin Exp Res. 2021 Oct 1;33(10):2709–14.
dc.relationGomez F, Curcio CL, Suriyaarachchi P, Demontiero O, Duque G. Differing approaches to falls and fracture prevention between Australia and Colombia. Clin Interv Aging. 2013;8:61–7.
dc.relationFolstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.
dc.relationFriedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329–35.
dc.relationBaker FM, Espino DV. A Spanish version of the geriatric depression scale in Mexican-American elders. Int J Geriatr Psychiatry. 1997;12(1):21–5.
dc.relationGómez JF, Curcio CL, Alvarado B, Zunzunegui M, Guralnik J. Validity and reliability of the Short Physical Performance Battery (SPPB): a pilot study on mobility in the Colombian Andes. Colomb Med. 2013;44(3):165–71.
dc.relationBaztán JJ, Pérez del Molino J, Alarcón T, San Cristóbal E, Izquierdo G, Manzarbeitia J. Índice de Barthel: instrumento válido para la valoración funcional de pacientes con enfermedad cerebrovascular. Rev Esp Geriatr Gerontol. 1993;28(1):32–40.
dc.relationRodríguez C, Lugo L. Validez y confiabilidad de la Escala de Tinetti para población colombiana. Rev Colomb Reumatol. 2012;19(4):218–33.
dc.relationBandura A. Self-Efficacy: Thought Control of Action. . Schwarzer R, editor. Washington, DC: Hemisphere Publishing Corporation; 1992.
dc.relationAyoubi F, Launay C, Annweiler C, Fantino B, Kabeshova A, Beauchet O. Fear of Falling, Falls, and Gait Variability in Older Community-Dwelling Individuals: Is There an Association? J Am Geriatr Soc. 2013;61:1236–8.
dc.relationLiu JY. Fear of falling in robust community-dwelling older people: results of a crosssectional study. J Clin Nurs. 2015;24(3–4):393–405.
dc.relationDelbaere K, Close J, Brodaty H, Sachdev P, Lord S. Determinants of disparities between perceived and physiological risk of falling among elderly people: Cohort study. BMJ. 2010;341–4165.
dc.relationHughes CC, Kneebone II, Jones F, Brady B. A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people. Int Psychogeriatr. 2015;27(7):1071–87.
dc.relationPeeters G, Bennett M, Donoghue OA, Kennelly S, Kenny RA. Understanding the aetiology of fear of falling from the perspective of a fear-avoidance model - A narrative review. Clin Psychol Rev. 2020;79:101862.
dc.relationSchwarzer R. Self-efficacy in the adoption and maintenance of health behaviors. Theoretical approaches and a new model. In: Self-Efficacy: Thought Control of Action. Washington, DC: Hemisphere Publishing Corporation; 1992.
dc.relationSchwarzer R FR. Changing risk behaviors and adopting health behaviors. The role of self-efficacy beliefs. In: Self-Efficacy in Changing Societies. Cambridge, UK: Cambridge University Press; 1995.
dc.relationMiyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cogn Psychol. 2000;41(1):49–100.
dc.relationCowan N. The many faces of working memory and short-term storage. Psychon Bull Rev. 2017;24(4):1158–70.
dc.relationKelly ME, Duff H, Kelly S, McHugh JE, Brennan S, Lawlor BA, et al. The impact of social activities, social networks, social support and social relationships on the 42 cognitive functioning of healthy older adults: a systematic review. Syst Rev. 2017;6(1):259.
dc.relationHalford GS, Cowan N, Andrews G. Separating cognitive capacity from knowledge: a new hypothesis. Trends Cogn Sci. 2007;11(6):236–42.
dc.relationDing D, Chen Y, Lai J, Chen X, Han M, Zhang X. Belief Bias Effect in Older Adults: Roles of Working Memory and Need for Cognition. Front Psychol. 2020;10:2940.
dc.relationNaveh-Benjamin M, Cowan N. The roles of attention, executive function and knowledge in cognitive ageing of working memory. Nat Rev Psychol. 2023;2:151– 65.
dc.relationHensel A, Angermeyer MC, Riedel-Heller SG. Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination. J Neurol Neurosurg Psychiatry. 2007;78(12):1298–303.
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightshttp://purl.org/coar/access_right/c_abf2
dc.subjectMiedo a caer
dc.subjectDeterioro cognoscitivo
dc.subjectAncianos
dc.subjectCaídas
dc.subjectCiencias médicas
dc.titleSeguimiento del estado cognoscitivo en ancianos con miedo a caer, sin deterioro cognoscitivo, evaluados en una clínica de inestabilidad, vértigo y caídas
dc.typeTrabajo de grado - Especialización
dc.typehttp://purl.org/coar/resource_type/c_bdcc
dc.typeText
dc.typeinfo:eu-repo/semantics/masterThesis
dc.typehttps://purl.org/redcol/resource_type/TM
dc.typeinfo:eu-repo/semantics/publishedVersion


Este ítem pertenece a la siguiente institución