ASOCIACIÓN ENTRE DECLIVE FUNCIONAL Y ENFERMEDAD TERMINAL EN PACIENTES ADULTOS MAYORES DE UNA UNIDAD DE CUIDADOS PALIATIVOS
Creators: name: Montoya, Gerardo
name: Runzer, Fernando
name: Uría, María Luisa Galindo
name: Arroyo, Noraliz Oliva
name: Agüero, Carolina Pérez
Publisher: name: figshare
Year: 2022
Subjects: subject: 110308 Geriatrics and Gerontology
subject: FOS: Clinical medicine
subject: Diseases

description: Introduction: The elderly population has increased markedly globally in recent years. Worldwide, it’s estimated that by 2050 it will represent 15.7% of the population, equivalent to more than 2 billion. A common characteristic of this age group is the loss of functionality that, added to other pathologies, increases their vulnerability and mortality. In this study, the Barthel index was used to compare functional decline in end-stage oncological and nononcological diseases, since it has not been previously studied in our country. <br> Objective: To determine the degree of functional impairment during terminal illness in older adult patients with oncological vs. non-oncological disease in a palliative care unit. <br> Patients and Methods: Retrospective cohort study in which two values of the Barthel index taken at admission were used to compare the functional decline of the elderly with different terminal pathologies, one taken at the time of hospitalization and the other calculated considering the anamnesis of the patient from three months ago.For data collection, we include patients admitted in the Geriatric Palliative Care service of the Naval Medical Center between the years 2018 and 2020. <br> Results: Thirty-two (57.14%) of 56 patients were male; the average age was 81.2 years (from: 10.8); 20 (35.7%) came from an outpatient clinic; 29 (51.8%) had advance directives; 37 (66.07%) had a diagnosis of oncological disease and 19 (33.9%) had non-oncological disease. The bivariate analysis between terminal illness and the variation of the Barthel Index (p = 0.14) was not statistically significant, but it was found to be significant in the relationship calculated used the Lawton index(p = 0.03), finding that the variation in cancer patients was greater [- 2.31 (± 2.91)] than in non-cancer patients [-0.88 (± 1.62)]. <br> Discussion: The purpose of our study was to determine the association between functional decline and type of terminal disease diagnosis. This study found that both basic and essential activities of daily living in patients with oncological disease, the functional decline was greater than in patients with chronic diseases. Although we only found statistical significance with the Lawton scale and not when using the Barthel scale, we were able to corroborate with studies who had a larger sample size that there is a more marked and acute decrease in ADL in patients with oncological disease as opposed to those with non - oncological terminal diseases. <br> Conclusion: A major functional impairment exists in patients that suffer from oncology disorders than patients who suffer non - oncology related disorders. This can be measured most precisely using the Lawton Scale, which evaluates the most essential activities of everyday life, those of which can be more complex and require a greater skill of autonomy to complete when compared to basic activities, which we measure with the Barthel Scale