INTRODUCTION: Chronic non-communicable diseases are the leading cause of death worldwide, except in Sub-Saharan Africa. Nonetheless, one of these conditions, dementia, is the major contributor to disability-adjusted life years in people aged >60 years. Few epidemiological studies exist of the prevalence and impact of dementia and selected chronic diseases in older adults in Latin America. OBJECTIVE: Describe prevalence of dementia, other chronic vascular diseases and cardiovascular risk factors, as well as resulting disabilities and care needs generated in adults aged >65 years in Havana City and Matanzas provinces, Cuba. METHODS: The 10/66 study is a prospective longitudinal study involving a cohort of 3015 adults aged >65 years in municipalities of Havana City and Matanzas provinces, divided into two phases: a cross-sectional door-to-door study conducted in 2003-2006, and a follow-up and assessment phase in 2007-2010. This article reports findings from the first phase. Hypertension diagnosis was based on criteria from the International Society for Hypertension; diabetes mellitus on American Diabetes Association criteria; stroke according to WHO definitions; and dementia according to criteria of the American Psychiatric Society's Diagnostic and Statistical Manual of Mental Disorders DSM-IV and the 10/66 International Dementia Research Group. Ischemic heart disease was defined by self-report of previous physician diagnosis. Study variables included age, sex, educational level, substance use (alcohol, tobacco) and dietary habits. A structured physical and neurological exam, including blood pressure measurement, was performed on all participants. Laboratory tests included complete blood count, fasting blood glucose, total cholesterol and lipoprotein fractions, triglycerides and apolipoprotein E genotype. Prevalence and standardized morbidity ratios (crude and adjusted) were calculated for chronic diseases studied with 95% confidence intervals, using a Poisson regression model and indirect standardization. RESULTS: The study assessed 2944 older adults (response rate 97.6%) and found high prevalence of vascular risk factors and of chronic non-communicable diseases: hypertension 73.0% (95% CI 71.4-74.7), diabetes mellitus 24.8% (95% CI 22.9-26.5), ischemic heart disease 14.1% (95% CI 12.9-15.4), dementia 10.8% (95% CI 9.7-12.0) and stroke 7.8% (95% CI 6.9-8.8). The majority of participants (85%) had more than one cardiovascular risk factor. The main cause of disability and dependency in the study population was dementia. CONCLUSION: The high prevalence of chronic diseases observed in the elderly-with the consequent morbidity, disability and dependency-highlights the need for prevention, early diagnosis and risk factor control, particularly given the demographic and epidemiologic transition faced by Cuba and other developing countries.

Introduction: The high blood pressure accounts for the 80% of death from cardiovascular and cerebrovascular disease in persons aged 65 and over. Objective: To determine the prevalence of the high blood pressure, the adherence to treatment and its control in elderly patients. Methods: A cross-sectional, descriptive and observational study was conducted in 1 216 elderly in four health areas selected from the Marianao and La Lisa municipalities from September, 2008 to September, 2009. Results: The adjusted high blood pressure prevalence was of 74,3% (95% CI 71,7-76,9) greater in female patients. The early detection of high blood pressure was higher to 70% in all polyclinics selected, but the adherence to treatment fluctuates between 47 and 68% and les than half of hypertensive ones were under control. Conclusions: To strength the primary health care to improve the high blood pressure care and control is the key in reduction of morbidity and mortality from cardiovascular diseases.

Introducción: La hipertensión arterial contribuye al 80 % de las muertes por enfermedad cardiovascular y cerebrovascular en la población de 65 años y más. Objetivo: Determinar la prevalencia de hipertensión arterial, adhesión al tratamiento y su control en adultos mayores. Métodos: Se realizó un estudio observacional descriptivo de corte transversal en 1 216 adultos mayores de 4 áreas de salud seleccionadas pertenecientes a los municipios Marianao y La Lisa, en el período de septiembre de 2008 a septiembre de 2009. Resultados: La prevalencia de hipertensión arterial ajustada fue de 74,3 (IC 95 % 71,7-76,9), con mayor prevalencia en las mujeres. La detección previa de hipertensión arterial resultó superior al 70 % en todos los policlínicos seleccionados, pero la adhesión al tratamiento osciló entre 47 y 68 %, y menos de la mitad de los hipertensos se encontraban controlados. Conclusiones: Fortalecer la atención primaria de salud para mejorar la atención y el control de la hipertensión arterial es clave en la reducción de la morbilidad y la mortalidad por enfermedades cardiovasculares.

A proposal of geriatric evaluation to be used in the Revolutionary Armed Forces due to the lack of a uniform methodology for the older adult care, is presented. It is suggested the application of the Comprehensive Geriatric Assessment to the retired officers from the Revolutionary Armed Forces and to the members of the Association of Combatants of the Cuban Revolution that receive medical attention in our health institutions. This assessment includes: biomedical evaluation (it refers to the medical history, nutritional assessment, Tinetti's test and a detailed ophthalmological and auditive examination), psychological evaluation (dementia and depression should be stressed according to the criteria of MHD-IV, with the support of the mini-examination of the mental status and of the scale of geriatric depression, respectively), social evaluation (it includes information about the socioeconomic and family situation, housing conditions and support recieved), and the functional evaluation (it explores the capacity for carrying out daily activities by the indexes of Karl, Lawton and of practical performance).

Se presenta una propuesta de evaluación geriátrica para su aplicación en las Fuerzas Armadas Revolucionarias, ante la carencia de una metodología uniforme para la atención del adulto mayor. Se sugiere la aplicación de la Valoración Geriátrica Integral a los jubilados de nuestras Fuerzas Armadas Revolucionarias y a los miembros de la Asociación de Combatientes de la Revolución Cubana que se atienden en nuestras instituciones médicas, esta valoración incluye: evaluación biomédica (se refiere a la historia clínica, valoración nutricional, prueba de Tinetti y un examen oftalmológico y auditivo detallado), evaluación psicológica (se debe destacar demencia y depresión según los criterios del Diagnóstico and Statistical Manual of Desorders IV, con el apoyo del mini-examen del estado mental y de la escala de depresión geriátrica respectivamente), evaluación social (recoge información sobre la situación socio-económica, familiar, de la vivienda y de soporte asistencial) y la evaluación funcional (explora la capacidad de realizar las actividades de la vida diaria a través de los índices de Katz, Lawton y de las ejecuciones prácticas).