Introducción. Varios aspectos en el adulto mayor deterioran su calidad de vida, como son las relaciones familiares y de amigos, la soledad e, incluso, el mismo centro geriátrico. Objetivo. Explorar las condiciones asociadas con la calidad de vida de los ancianos en hogares geriátricos. Materiales y métodos. Estudio transversal de 276 ancianos de 39 Centros de Bienestar del Anciano de Medellín. Se excluyeron aquellos con grave deterioro cognitivo y los que no residían de forma permanente en la institución. La calidad de vida se evaluó mediante el World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) de la Organización Mundial de la Salud; se utilizaron la escala de depresión de Yesavage, la de ansiedad de Goldberg, la de funcionalidad de Pfeffer, la minivaloración nutricional y, además, se evaluaron aspectos demográficos y sociales. La información se analizó con pruebas U de Mann-Whitney, Kruskal-Wallis, la correlación de Pearson y un modelo de regresión lineal múltiple. Resultados. El 59,4 % eran mujeres, la edad promedio fue de 79,2 ± 8,0 años, 71 % se consideraron independientes para realizar actividades de la vida diaria, 45,7 % presentaba sintomatología depresiva y 33 % mostraron riesgo de ansiedad, 28,3 % deterioro funcional y, 54,3 %, posible malnutrición. Se encontró una asociación negativa con la calidad de vida el ser mujer, presentar diabetes, altos puntajes en las escalas de capacidad funcional, depresión y ansiedad; el ir voluntariamente a la institución mostró una asociación positiva. Conclusión. Se halló deterioro en la calidad de vida cuando las condiciones de funcionalidad y autonomía limitaban la realización de actividades de la vida diaria, agravado por el hecho de ser mujer, tener sintomatología depresiva y de ansiedad, y sentirse maltratado por sus familiares.Palabras clave: calidad de vida, anciano, institucionalización, ansiedad, depresión. Quality of life in institutionalized elderly people of MedellínIntroduction. Many factors contribute to the deteriorating quality of life of elderly people living in care institutions. Some of these problems are a consequence of few contacts with relatives and friends, and being alone with a feeling of isolation. Objective. The conditions of quality of life are explored for elderly people living in care institutions. Materials and methods. In a cross sectional study, 276 subjects were selected from 39 long term institutions located in the city of Medellín, Colombia. The sex ratio was female:male 60:40% with a mean age of 79.2 ± 8.0. Elderly subjects with cognitive problems or not living in the institution were excluded. The World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) questionnaire was applied; in additional, capacity and cognitive functional scales of Pfeffer, the anxiety scale of Goldberg, and the Geriatric Depression Scale of Yesavage were administered. Mininutritional assessment scales and complementary questionnaires about demographics, health perception, social support system were also included. The inform...

Even today, there are wide health inequalities in Latin America and the Caribbean. The country with the most favorable health indicators was Cuba and that with the least favorable was Haiti. We recommend systematic evaluation of health inequalities in Latin America and the Caribbean through the Inequalities in Health Index and other indices, in order to analyze actions, policies and programs to reduce inequities in this region.

Objectives We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia. Methods We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to population census data. We used the relative index of inequality to compare disparities in mortality by education between periods of moderate increase (1998–2002) and accelerated increase (2003–2007) in health insurance coverage. Results Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from2.59 (95% confidence interval [CI] = 2.52, 2.67) in 1998–2002 to 3.07 (95% CI = 2.99, 3.15) in 2003–2007, and among women, from 2.86 (95% CI = 2.77, 2.95) to 3.12 (95% CI = 3.03, 3.21), respectively. Disparities increased yearly by 11% in men and 4% in women in 1998–2002, whereas they increased by 1% in men per year and remained stable among women in 2003–2007. Conclusions Mortality disparities widened significantly less during the period of increased health insurance coverage than the period of no coverage change. Although expanding coverage did not eliminate disparities, it may contribute to curbing future widening of disparities.

Objective To explore the association between the risk of depression and demographic, social and functional aspects of the elderly department of Antioquia in 2012. Materials and Methods A cross-sectional study of 4 248 seniors as a primary source. Demographic, social and functional characteristics were assessed. Crude OR was calculated and adjusted to find association between the risk of depression as measured by the Yesavage's Geriatric Depression Scale and other variables of interest. Results The risk of depression was associated with age, marital status, educational level, smoking and alcohol consumption, as with little or no participation in community activities (OR =1.9 , 95 % [1,2,3.0 ], the perception of poor quality of life (OR=10.0 , 95 % CI [ 2.0,48.8 ] and loss of functional capacity (OR=6.3, 95 % [29, 13.9 ]. Conclusions The risk of depression in the elderly is associated with more difficulty relating to their physical and emotional environment than to the biological condition of the disease. This is a situation that could be prevented if family ties are strengthened and with the aim of a more active and functional aging.

Objectives Non-communicable diseases have become the leading cause of death in middle-income countries, but mortality from injuries and infections remains high. We examined the contribution of specific causes to disparities in adult premature mortality (ages 25-64) by educational level from 1998 to 2007 in Colombia. Methods Data from mortality registries were linked to population censuses to obtain mortality rates by educational attainment. We used Poisson regression to model trends in mortality by educational attainment and estimated the contribution of specific causes to the Slope Index of Inequality. Results Men and women with only primary education had higher premature mortality than men and women with post-secondary education (RRmen=2·60, 95% confidence interval [CI]:2·56, 2·64; RRwomen=2·36, CI:2·31, 2·42). Mortality declined in all educational groups, but declines were significantly larger for higher-educated men and women. Homicide explained 55·1% of male inequalities while non-communicable diseases explained 62·5% of female inequalities and 27·1% of male inequalities. Infections explained a small proportion of inequalities in mortality. Conclusion Injuries and non-communicable diseases contribute considerably to disparities in premature mortality in Colombia. Multi-sector policies to reduce both interpersonal violence and non-communicable disease risk factors are required to curb mortality disparities.