Objective: To evaluate the association between life satisfaction and socioeconomic status and self-reported health in a cohort of older people in Santiago, Chile, in 2005 and 2006. Methods: We interviewed 2002 individuals aged 65 to 67.9 years registered in 20 primary care centers in the city of Santiago. Participants were living independently with no cognitive impairment, suspected cancer or terminal diseases. We assessed life satisfaction using an abbreviated adaptation of a life satisfaction scale (scored from 0 to 11), and collected self-reported information on income, education, social support, and self-reported health and memory. We used a log-binomial model to analyze the association between life satisfaction scores (fourth quartile compared with the first) and socioeconomic and health variables. Results: There was a significant association (bivariate and multivariate analyses) between life satisfaction and income in men and with social support, self-reported health, memory, and diagnosis of joint problems, diabetes and hypertension in both sexes. Conclusion: Social support, income and health status were independently associated with life satisfaction in older people aged 65-67.9 years in Santiago. Further studies are required to assess the temporal direction of the effect and the implications of these findings for public health policies in this population.

Objetivo: Evaluar la asociación entre satisfacción vital con el nivel socioeconómico y el autorreporte del estado de salud en una cohorte de adultos mayores de Santiago de Chile en los años 2005 y 2006. Métodos: Estudio transversal que incluyó 2002 sujetos entre 65 y 67,9 años de edad, registrados en 20 centros de salud primaria del Gran Santiago, autovalentes, sin deterioro cognitivo, sospecha de cáncer ni enfermedad terminal. Se evaluó la satisfacción vital mediante la adaptación abreviada de una escala de satisfacción con la vida (de 0 a 11), además de los ingresos económicos, el nivel de educación, el apoyo social y autorreporte del estado de salud y la memoria. Se utilizó un modelo log-binomial para analizar la asociación entre las variables evaluadas y los extremos del puntaje de satisfacción vital (cuartil 4 frente a 1). Resultados: Se observó una asociación significativa (análisis bivariado y multivariado) entre satisfacción vital e ingresos económicos en los hombres, y en ambos sexos con el apoyo social, el autorreporte de salud, la memoria y los diagnósticos de problemas articulares, diabetes e hipertensión. Conclusión: La situación económica, el apoyo social y el estado de salud se asocian de forma independiente con la satisfacción vital en los adultos mayores de Santiago. Se requieren nuevos estudios para evaluar la dirección temporal del efecto, así como las implicaciones de estos hallazgos en las políticas públicas de salud en esta población.

Objective: To evaluate the association between life satisfaction and socioeconomic status and self-reported health in a cohort of older people in Santiago, Chile, in 2005 and 2006. Methods: We interviewed 2002 individuals aged 65 to 67.9 years registered in 20 primary care centers in the city of Santiago. Participants were living independently with no cognitive impairment, suspected cancer or terminal diseases. We assessed life satisfaction using an abbreviated adaptation of a life satisfaction scale (scored from 0 to 11), and collected self-reported information on income, education, social support, and self-reported health and memory. We used a log-binomial model to analyze the association between life satisfaction scores (fourth quartile compared with the first) and socioeconomic and health variables. Results: There was a significant association (bivariate and multivariate analyses) between life satisfaction and income in men and with social support, self-reported health, memory, and diagnosis of joint problems, diabetes and hypertension in both sexes. Conclusion: Social support, income and health status were independently associated with life satisfaction in older people aged 65-67.9 years in Santiago. Further studies are required to assess the temporal direction of the effect and the implications of these findings for public health policies in this population.

Objetivo: Evaluar la asociación entre satisfacción vital con el nivel socioeconómico y el autorreporte del estado de salud en una cohorte de adultos mayores de Santiago de Chile en los años 2005 y 2006. Métodos: Estudio transversal que incluyó 2002 sujetos entre 65 y 67,9 años de edad, registrados en 20 centros de salud primaria del Gran Santiago, autovalentes, sin deterioro cognitivo, sospecha de cáncer ni enfermedad terminal. Se evaluó la satisfacción vital mediante la adaptación abreviada de una escala de satisfacción con la vida (de 0 a 11), además de los ingresos económicos, el nivel de educación, el apoyo social y autorreporte del estado de salud y la memoria. Se utilizó un modelo log-binomial para analizar la asociación entre las variables evaluadas y los extremos del puntaje de satisfacción vital (cuartil 4 frente a 1). Resultados: Se observó una asociación significativa (análisis bivariado y multivariado) entre satisfacción vital e ingresos económicos en los hombres, y en ambos sexos con el apoyo social, el autorreporte de salud, la memoria y los diagnósticos de problemas articulares, diabetes e hipertensión. Conclusión: La situación económica, el apoyo social y el estado de salud se asocian de forma independiente con la satisfacción vital en los adultos mayores de Santiago. Se requieren nuevos estudios para evaluar la dirección temporal del efecto, así como las implicaciones de estos hallazgos en las políticas públicas de salud en esta población.

BACKGROUND: Evidence from observational studies suggests that diets high in omega-3 long-chain polyunsaturated fatty acids (PUFA) may protect people from cognitive decline and dementia. The strength of this potential protective effect has recently been tested in randomized controlled trials. OBJECTIVES: To assess the effects of omega-3 PUFA supplementation for the prevention of dementia and cognitive decline in cognitively healthy older people. METHODS: Search: We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register on - 6 April 2012 using the terms: "omega 3", PUFA, "fatty acids", "fatty acid", fish, linseed, eicosapentaenoic, docosahexaenoic. Selection criteria: Randomised controlled trials of an omega-3 PUFA intervention which was provided for a minimum of six months to participants aged 60 years and over who were free from dementia or cognitive impairment at the beginning of the study. Two review authors independently assessed all trials. Data collection and analysis: The review authors sought and extracted data on incident dementia, cognitive function, safety and adherence, either from published reports or by contacting the investigators for original data. Data were extracted by two review authors. We calculated mean difference (MD) or standardised mean differences (SMD) and 95% confidence intervals (CI) on an intention-to-treat basis, and summarized narratively information on safety and adherence. MAIN RESULTS: Information on cognitive function at the start of a study was available on 4080 participants randomised in three trials. Cognitive function data were available on 3536 participants at final follow-up. In two studies participants received gel capsules containing either omega-3 PUFA (the intervention) or olive or sunflower oil (placebo) for six or 24 months. In one study, participants received margarine spread for 40 months; the margarine for the intervention group contained omega-3 PUFA. Two studies had cognitive health as their primary outcome; one study of cardiovascular disease included cognitive health as an additional outcome. None of the studies examined the effect of omega-3 PUFA on incident dementia. In two studies involving 3221 participants there was no difference between the omega-3 and placebo group in mini-mental state examination score at final follow-up (following 24 or 40 months of intervention); MD-0.07 (95% CI -0.25 to 0.10). In two studies involving 1043 participants, other tests of cognitive function such as word learning, digit span and verbal fluency showed no beneficial effect of omega-3 PUFA supplementation. Participants in both the intervention and control groups experienced either small or no cognitive declines during the studies. The main reported side-effect of omega-3 PUFA supplementation was mild gastrointestinal problems. Overall, minor adverse events were reported by fewer than 15% of participants, and reports were balanced between intervention groups. Adherence to the intervention was on average over 90% among people who completed the trials. All three studies included in this review are of high methodological quality. AUTHORS' CONCLUSIONS: Direct evidence on the effect of omega-3 PUFA on incident dementia is lacking. The available trials showed no benefit of omega-3 PUFA supplementation on cognitive function in cognitively healthy older people. Omega-3 PUFA supplementation is generally well tolerated with the most commonly reported side-effect being mild gastrointestinal problems. Further studies of longer duration are required. Longer-term studies may identify greater change in cognitive function in study participants which may enhance the ability to detect the possible effects of omega-3 PUFA supplementation in preventing cognitive decline in older people.

Background: Community acquired pneumonia (CAP) has a high mortality rate among older people. To increase its treatment efficiency, the Chilean Ministry of Health elaborated a clinical management guideline for CAP. Aim: To assess the degree of compliance with the clinical guidelines for CAP among professionals working at primary health care centers. Material and methods: A follow up of a cohort of 2,797 subjects aged 67 years or more, incorporated to a clinical study. All cases of bronchopneumonia or pneumonia diagnosed at primary health care centers between September 2005 and June 2008 were recorded. Results: During the follow up period, 192 cases of CAP were diagnosed. A chest X-ray was requested in 81% of cases and a confirmation consultation was done in 58%. Amoxicillin/ Clavulanic acid was the most common antimicrobial prescription in 61% of cases, followed by Clarithromycin in 17% and Amoxicillin in 12%. The antimicrobial used was not registered in 5% of cases. Conclusions: The clinical guidelines improve the efficiency of CAP treatment and decrease complications. However, these guidelines must been complemented with an adequate training and supervision of health care teams.