Papers by Sergio Sánchez-garcia
Clinical Interventions in Aging, 2021
Purpose: To identify factors associated with recovered functionality after a hip fracture in a sa... more Purpose: To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients. Patients and Methods: Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality. Results: A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (±8.7) overall; for cases, 77.4 (±7.9) years and for controls, 81.4 (±9.0). Mean schooling was 6.3 (± 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54-9.12), absence of heart disease (OR 4.08, 95% CI = 1.48-11.20), selfefficacy for ADL (OR 4.07, 95% CI = 2.15-7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69-5.28), prior functionality (OR 2.83, 95% CI = 1.51-5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24-4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05-5.22). Conclusion: In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.
Clinical Interventions in Aging, 2019
The present study aims to explore characteristics associated with low perception of autonomy amon... more The present study aims to explore characteristics associated with low perception of autonomy among community-dwelling older adults. Patients and methods: This original research was derived from a cross-sectional study based on the study COSFOMA with information from 1,252 (60 years and older) communitydwelling older adults whose data was obtained through a questionnaire that included sociodemographic characteristics, as well as different scales of geriatric assessment. The perception of autonomy was evaluated with the autonomy sub-scale of the Quality of Life Scale of Older Adults from the World Health Organization (World Health Organization Quality of Life of Older Adults, WHOQOL-OLD). Results: The mean (SD) age of the 1,252 community-dwelling older adults participating in the study was 68.5 (7.2) years. The average perception of autonomy was 65.3 (18.2) points out of 100. In the final logistic regression model, schooling <6 years (Odds Ratio, OR = 2.1, 95% Confidence Interval, CI = 1.5-2.9), low social support (OR = 1.6, 1.2-2.2), low spirituality (OR = 2.6, 95% CI = 1.9-3.4), presence of cognitive impairment (OR = 1.9, 95% CI = 1.4-2.5), anxiety (OR = 1.7, 95% CI = 1.2-2.5), and limitation in activities of daily living (ADL) (OR = 1.6, 95% CI = 1.1-2.2) were statistically associated with the presence of low autonomy in older adults. Conclusion: The perception of autonomy among community-dwelling older adults is moderate. Social support and spirituality, as well as cognitive impairment, anxiety, and limitations in ADL, play a significant role for degree of perceived autonomy in this population. Health professionals can use this information to promote participation in decisionmaking processes through programs that improve quality of life.
Salud Mental, Feb 1, 2012
The present review aims at analyzing the magnitude and social impact of depression, as well as ex... more The present review aims at analyzing the magnitude and social impact of depression, as well as exploring models that help to understand the strategies needed to address this public health problem. The literature reveals that 9.2% of the general population has had a depressive episode and one in five persons will have an episode by age 75. Lower rates are observed in low and mid income in comparison to those with high income. These differences are not due to personal income, the probability of greater severity or delay in diagnosis, and are more likely related to cultural differences. Greater risk is observed among females, people younger than 60 years, marital status as single, widowed or divorced, and low educational attainment. The deleterious effect of depression on productivity is well established (27 days lost in the past year, on average, per case). The association with diabetes, hypertension, cardio vascular disease, drug use, suicide, and other risk behaviors has been frequently observed. Although unresolved questions remain about the presence or not of common risk factors and the chain of causality, it is a known fact that the combination of physical and mental disorders causes greater disability. With regard to the healthcare system, patients with depression and/or anxiety have higher utilization rates and healthcare costs, particularly among elderly patients. This healthcare overutilization is related with the low rates of diagnosis and adequate treatment of depression. About 26% of depression cases will not be diagnosed and, although a large proportion of patients have contact with healthcare services, nearly 30% never receive help for their depression. New treatment models that overcome barriers, understanding the sociocultural factors related with the problem, and addressing depression at the primary level of healthcare are urgent in Mexico.
International Psychogeriatrics, 2009
ABSTRACTBackground: The Mini-mental State Examination (MMSE) is the most widely used cognitive te... more ABSTRACTBackground: The Mini-mental State Examination (MMSE) is the most widely used cognitive test, both in clinical settings and in epidemiological studies. However, correcting its score for education may create ceiling effects when used for poorly educated people and floor effects for those with higher education.Methods: MMSE and a recent cognitive test, the seven minute screen (7MS), were serially administered to a community sample of Mexican elderly. 7MS test scores were equated to MMSE scores. MMSE-equated 7MS differences indicated ceiling or floor effects. An ordinal logistic regression model was fitted to identify predictors of such effects.Results: Poorly educated persons were more prevalent on the side of MMSE ceiling effects. Concentration (serial-sevens), orientation and memory were the three MMSE subscales showing the strongest relationship to MMSE ceiling effects in the multivariate model.Conclusion: Even when MMSE scores are corrected for educational level they still ...
Salud Mental, 2015
Background. Depression is associated with an increased use of medical resources and reduced quali... more Background. Depression is associated with an increased use of medical resources and reduced quality of life, cognitive functions, functionality and general health. The treatment of depression is limited by the scarcity of mental health professionals, as reflected in the mental health atlas of the World Health Organization. Method. A randomised controlled trial that was not blinded was conducted. Family doctors referred patients older than 60 years who were suspected to have depression to the screening module. The PHQ-9 questionnaire, the Six-Item Screener, and previous diagnosis for psychiatric disorders were collected. Major depression was excluded. Those with a score from two to six on the PHQ-9 and with no comorbidities were referred to the Baseline Phase. A simple random process without blocking was applied. Groups of 7-10 participants engaged in weekly sessions over the course of three months. The control group was referred to their family physician. Reduction in depression sco...
Social Psychiatry and Psychiatric Epidemiology, 2014
Purpose Determine the structure of depressive symptoms among adolescents and older adults through... more Purpose Determine the structure of depressive symptoms among adolescents and older adults through the personcentered approach of latent class analysis (LCA). Methods The study is based on data from two independent samples collected in Mexico City (2,444 adolescents and 2,223 older adults) which included the revised version of the CES-D. The presence or absence of depressed mood (dysphoria), diminished pleasure (anhedonia), drastic change in weight, sleep problems, thinking and concentration difficulties, excessive or inappropriate guilt, fatigue, psychomotor agitation/retardation, and suicide ideation were used in LCA to determine the structure of depressive symptoms for adolescents and older adults.
Psychiatric Genetics, 2010
Journal of Allergy and Clinical Immunology, 2008
Journal of Allergy and Clinical Immunology, 2009
The clinical features of patients with oral allergy syndrome (OAS) due to plant-derived foods hav... more The clinical features of patients with oral allergy syndrome (OAS) due to plant-derived foods have been rarely reported in Japan. We investigated whether pollen sensitizations would be correlated with prevalence of OAS. METHODS: We measured specific IgE antibodies (ImmunoCAP: CAP) against Japanese cedar, alder, orchard grass, ragweed, and mugwort in 622 outpatients (M: F 5 277:345, mean age, 37 years) with skin allergy over a two-year period.We statistically analyzed whether there was any correlation between prevalence of OAS and sensitization to the pollens. RESULTS: Prevalence of OAS is 2.3% in outpatients with skin allergy. Ratios of positive response to CAP against Japanese cedar, alder, orchard grass, ragweed, and mugwort were 69.8%, 24.1%, 29.1%, and 35.3%, respectively. Prevalence of OAS showed a significant positive correlation (p < 0.001) with sensitization to alder, but no correlation with sensitization to Japanese cedar, orchard grass, ragweed, and mugwort. The most frequent causative foods were found to be apple, peach, melon, and kiwi. Prevalence of OAS due to apple showed a significant positive correlation (p < 0.001) with sensitization to alder. Prevalence of OAS due to peach showed a significant positive correlation (p < 0.001 and p < 0.05) with sensitization to alder and orchard grass. Further, prevalence of OAS due to melon showed a significant positive correlation (p < 0.005, p < 0.05 and p < 0.05) with sensitization to alder, orchard grass, and ragweed. CONCLUSIONS: In this study, it was suggested that the sensitization to the pollens from species belonging to Betulaceae family would be most strongly involved in prevalence of OAS in Japan as same as in Northern and Center Europe.
Journal of Allergy and Clinical Immunology, 2011
Journal of Allergy and Clinical Immunology, 2010
OBJECTIVES: NSAIDs are the most important anti-inflammatory agents. From adverse reactions, the m... more OBJECTIVES: NSAIDs are the most important anti-inflammatory agents. From adverse reactions, the most frequent is hypersensitivity due to cross intolerance. The need to find a safe alternative drug is a common clinical problem. Previous studies have shown that COX-2-selective inhibitors (COX-2-SI) are usually well tolerated in these patients. The aim was establish tolerance of etoricoxib in patients with skin cross intolerance hypersensitivity reactions to NSAIDs including paracetamol. METHODS: Patients with NSAIDs skin reactions were studied. Cross intolerance was confirmed by clinic history and/or challenge. In those reacting to paracetamol as well a group with tolerance to it, we assessed the response to etoricoxib by oral provocation. RESULTS: We evaluated 268 patients with skin reactions and confirmed NSAIDs hypersensitivity. The 59,7% was female and 40,03 6 15,61 years old. Ibuprofen was the most frequent NSAID involved (56,7%), followed by ASA (50,7%) and metamizol (34,7%). The most frequent entity was urticaria (48,5%) and most of the reactions (46,7%) occurred less than 1hour after drug intake. We carried our 192 challenges in 147 patients, being positive 46. A total of 52 patients responded to paracetamol. In this group, 13 patients (25%) presented symptoms after receiving etoricoxib. In a representative sample of 80 cases with good tolerance to paracetamol, etoricoxib was also tolerated. CONCLUSION: Although most of studies attributed good tolerance to COX-2-selective inhibitors in patients with skin symptoms induced by multiple NSAIDs, the incidence for reactions found in our group was higher. A condition to find positive cases was confirmed intolerance to paracetamol.
International Journal of Geriatric Psychiatry, 2014
The EuroQoL-5D (EQ-5D) is a brief, multi-attribute, preference-based health status measurement. T... more The EuroQoL-5D (EQ-5D) is a brief, multi-attribute, preference-based health status measurement. The objective of this study was to assess the validity and reliability of EQ-5D in older adults with and without dementia in Mexico City. The Study on Aging and Dementia in Mexico (SADEM) was a survey of 3101, Mexican adults (60 + years old). An in-home face-to-face interview was administered. EQ-5D using ranking to rate states on a 100-point visual analogue scale; Daily Living Activities (ADL), Instrumental Activities of Daily Living (IADL), Mini Mental State Examination (MMSE), Short Form of the quality of life survey (SF-36), and Charlson comorbility index were used for comparison. The validity and reliability of EQ-5D were tested. We identified states of health for direct valuation; state 11111 (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no problems&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;) had to be included because it was essential to the reseating (onto a 0-1 scale) of the visual analogue scale data. We included all plausible combinations of levels across each of the five EQ-5D dimensions and evaluated any significant interaction effects and factorial designs, based on balanced complete blocks. The EQ-5D was applied to 3101 older people, of whom 109 (3.4%) had dementia. The general reliability of EQ-5D for cases was 0.80 and for controls 0.76, for each dimension. We had a total of 103 combinations for controls and 45 for cases. The percentage for the state of health &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;no problems&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (11111) for controls was 30.4%, and had the highest percentage of cases (8.8%). The resulting valuations form the basis for clinical use and facilitate the interpretation and evaluation of health care.
Int. Journal of Clinical Pharmacology and Therapeutics, 2012
Geriatrics & Gerontology International, 2014
To estimate the prevalence of frailty phenotypes and their association with the sociodemographic ... more To estimate the prevalence of frailty phenotypes and their association with the sociodemographic characteristics, health state and the use of health services in the last 6 months among community-dwelling elderly in Mexico City.
Experimental and Molecular Pathology, 2006
Angiotensin-I-converting enzyme (ACE) insertion/deletion (ID) polymorphism has been associated wi... more Angiotensin-I-converting enzyme (ACE) insertion/deletion (ID) polymorphism has been associated with the genetic susceptibility to coronary artery disease (CAD) and also with the lipid profile in several populations. In the present work, we analyzed the distribution of ID polymorphism in 147 Mexican patients with CAD and 100 unrelated healthy controls. The correlation of this polymorphism with the lipid profile (cholesterol, low density lipoprotein-cholesterol, very low density lipoprotein-cholesterol, high density lipoprotein-cholesterol and triglycerides) in the patients group was determined. Increased frequency of D allele as well as DD genotype and decreased frequency of I allele and II genotype were found in CAD patients group (pC = 0.00058, OR = 1.96, pC = 0.021, OR = 2.5 and pC = 0.00058, OR = 0.51, pC = 0.0028, OR = 0.38). Correlation between ID genotypes and lipid profile in patients was carried out in total population and separately for females and males. After they had been adjusted for age, sex and BMI, there was no association among the three genotypes (II, ID and DD) and lipids and lipoproteins in none of the studied groups. Our data suggest that genetic variation at the ACE is a genetic factor related with the susceptibility to coronary artery disease in the Mexican Mestizo population.
European Journal of Cancer, 2007
Genotypes Human papilloma virus Polymerase-chain-reaction Polymorphisms P450 cytochrome Risk fact... more Genotypes Human papilloma virus Polymerase-chain-reaction Polymorphisms P450 cytochrome Risk factors Smoking A B S T R A C T The aim of the study was to evaluate the association of two CYP1A1 polymorphisms (Msp1 and exon 7) with cervical cancer in Mexican women considering their smoking habit. The polymorphisms were determined in 310 individuals (155 with cervical cancer and 155
BMC Health Services Research, 2007
The aging population poses a challenge to Mexican health services. The aim of this study is to de... more The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older.
BMC Health Services Research, 2009
Background: Ageing of Mexican population implies greater demand of hospital services. Nevertheles... more Background: Ageing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated.
Alzheimer's & Dementia, 2014
Background: Epidemiologic studies on mild cognitive impairment (MCI) are limited in China. Method... more Background: Epidemiologic studies on mild cognitive impairment (MCI) are limited in China. Methods: Using a multistage cluster sampling design, a total of 10,276 community residents (6096 urban, 4180 rural) aged 65 years or older were evaluated and diagnosed with normal cognition, MCI, or dementia. MCI was further categorized by imaging into MCI caused by prodromal Alzheimer's disease (MCI-A), MCI resulting from cerebrovascular disease (MCI-CVD), MCI with vascular risk factors (MCI-VRF), and MCI caused by other diseases (MCI-O). Results: The prevalences of overall MCI, MCI-A, MCI-CVD, MCI-VRF, and MCI-O were 20.8% (95% confidence interval [CI] 5 20.0-21.6%), 6.1% (95% CI 5 5.7-6.6%), 3.8% (95% CI 5 3.4-4.2%), 4.9% (95% CI 5 4.5-5.4%), and 5.9% (95% CI 5 5.5-6.4%) respectively. The rural population had a higher prevalence of overall MCI (23.4% vs 16.8%, P , .001). Conclusions: The prevalence of MCI in elderly Chinese is higher in rural than in urban areas. Vascular-related MCI (MCI-CVD and MCI-VRF) was most common.
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Papers by Sergio Sánchez-garcia