INTRODUCTION

The World Health Organization (WHO) considers an older adult as someone above 60 years of age. In 2018, there were 125 million people existed over 80 years of age, it is estimated that in 2050 the same number of older adults remain in China alone and 434 million in the rest of the world. In 2050, 80% of older adults will live in developing countries¹. According to Instituto Nacional de Estadística e Informática (INEI), for the year 2020, Peru presented 4 million 140 thousand older adults which represented 12.7% of the total population, of which 15.6% are over 80 years of age, and 77.9% have a chronic disease².

Encouraging older adults to adopt a healthy lifestyle may reduce their risk of developing a disability. The definitions of health and wellbeing in elderly have hanged with the increase in life expectancy. Cardiac diseases, cancer, and cerebrovascular diseases (CVD) have become the primary causes of death among older adults, while deaths due to infection have decreased. Currently, 80% of elderly with a mean age of 70 years are female, and 53% of elderly presented with arterial hypertension, 25% diabetes, and 8% CVD³. Adults that live to an advanced age suffer from high rates of non-transmissible chronic disease related to factors such as overweight, obesity, problems in blood pressure, diabetes, and altered lipid profile, and 80% have at least one and 50% have at least two chronic diseases^4,5.

There is a strong association between the presence of geriatric syndromes (cognitive decline, incontinence, visual or auditive decline, low body mass index (BMI), dizziness) and dependence in daily life activities, and this problem is more pronounced in older adults residing in rural areas^5,6.

Alcohol use in older adults is associated with a greater risk of falls and could negatively affect function and cognition, as well as general health. Risk factors of alcohol use among older adults include grieving, depression, anxiety, pain, disability and prior history of alcohol use⁵.

Smoking is a harmful habit that impacts quality of life as well as morbidity and mortality⁷. Smoking rates and tobacco use are lowest among older adults above 65 years of age than for younger people. However, the older generation has a longer history of high rates of smoking and an excess of mortality related to smoking by lung cancer, cardiovascular disease and chronic obstructive pulmonary disease⁵and, furthermore, the excessive use of industrialized drinks, such as soft drinks, and bad eating habits lead to overweight and obesity, and these in turn lead to chronic diseases such as Type II Diabetes and cardiovascular diseases⁸. associated.

This study’s objective was to determine which are the characteristics related to lifestyle in elderly patients in a health center of the Andes in Peru. This research was important because it allowed us to identify the condition in which the older adults in Peru find themselves, and therefore, create health promotion and prevention plans in the primary level of care in order to make decisions to improve their quality of life.

METHODS

RESULTS

From the 78 registered patients, the age mean was 75.4 ± 9.8. Regarding sex, masculine sex represented 47.4% (37) and feminine sex 52.6% (41).

The average height of men was 154.1±7.1 and of women was 147.3±6.0, the weight had an average of 57.6 for men with an interquartile range of 53.1 and 62.3, however for women it was 53,0 with an interquartile range of 48.5 and 62, the BMI was an average of 24.7±3.1 in men, but in women it was 25.0±3.7. Only 27 older adults were of normal weight, 12 men and 11 women were overweight, and only 2 women and 1 man were obese (Table 1).

According to the clinical data on visual acuity, 70 is the most frequent measure among men and women (32.7%) where 55.6% are men and 44.4% are women. The most frequent measure of visual acuity in the left eye was 50 (36.4%) which both men and women share 50% (Table 2).

In laboratory variable, we found that glucose in men had a median of 97.0 and an interquartile range of 92.2 and 108.0 and a median of glucose in women of 97.6 with an interquartile range of 87.5 and 107.0. We can observer that the median of hemoglobin was 15.4 in men with an interquartile range of 15.0 and 16.1 and in women the mean was 15.1 with an interquartile range of 14.,1 and 15.4. Regarding the corrected hemoglobin, the mean in men was 13.1 ± 1.1 and in women 13± 1.2 with a total mean of 12.9±1.2. Regarding triglycerides, the average was 182,2 ± 20,8 where men had a mean of 177,2 ± 21,1 and women had a mean of 187,9 ±19,8. Other data of this type can be seen inTable 3.

Regarding the comorbidities such as Diabetes Mellitus, 4% represent those that have diabetes where only 3 women have diabetes mellitus and 96% do not have it. On the other hand, arterial hypertension, 21,6% presented it, of which 11(68,7%) women presented it and only 5 (31,3%) men presented it and 78,4% did not have arterial hypertension. Regarding anemia, 22,2% presented it, 4 men (50%) and 4 women (50%) presented with anemia and 77,8% did not. (Table 4)

We observed that 29,7% consumed alcohol, of which only 40,9% of men consume alcohol and 59,1% of women consume it and 29,7% do not consume alcohol. We found that 6,8% had behaviors regarding smoking where 80% were men and 20% women and 93,2% did not present smoking behavior. Regarding coca cola use, 89,2% consume it, of which 48,5% were men and 51,5% were

women and 10,8% did not consume it. (Table 5)

DISCUSSION

The importance of improving lifestyle in older adults is related to a better quality of life and reducing risk factors for developing complications of chronic diseases and therefore increase longevity. In this study we evidenced that the mean age o folder adults was 74,5 ±9,8 and 52% were of the feminine sex.

Base don anthropometric data, the median weight was 55,5 with an interquartile range of 51,1 and 62, the height and BMI mean was 150,8 cm ± 7,5 and 24,8 ± 3,4, respectively. These results are correlated with the Barron study published in 2017, where it is mentioned that older adults are normal weight, men as well as women (57,3% and 53,7% respectively)⁽¹⁵, which would explain that a good lifestyle, with respect to nutritional habits and physical exercise. Considering that the rural population studied performs agricultural and livestock work, this probably keeps their BMI within acceptable values.

Regarding visual acuity, we found that in the right eye, visual acuity of 20/70 obtained the greater percentage of 32,7%, while, in the left eye 36,4% had a visual acuity of 20/50. In the study performed by Duran Badillo et al. in 2019 in Mexico, they evidenced that visual acuity in older adults in the right eye was 20/100 (36,2%) in first place, followed by 20/40 (30,9%), while in the left eye, visual acuity of 20/100 (39,4%) was first place and in second place was 20/40 (23,4%)¹⁶. It is important to consider that both studies resulted in a decreased visual acuity, since decreased visual acuity implies an increase in dependence for basic activities of daily life, which could lead to an increase in morbidity and mortality. It is important to emphasize the care of eye health especially in rural populations, where ophthalmological evaluations are not performed frequently.

Regarding the presence of comorbidities in older adults, in our study we obtained taht 4% had Diabetes Mellitus, 21,6% had Arterial Hypertension, and the mean of triglycerides was 182,2 ± 20,8. In 2018 in Mexico, Alejandro Vega-Quintana performed a study where he tells us that the principle causes of comorbidity in a population of 324 older adults were: arterial hypertension 74.6% and diabetes mellitus: 37%¹⁷. The presence of comorbidities is associated with an increase in morbidity and mortality in older adults, which is why it is important to promote a healthy lifestyle, in order to reduce the presence of these or decrease the acute and chronic complications that they could generate.

Regarding alcoholic drinks and tobacco, we evidenced that older adults consumed them in 29,7% and 6,8%, respectively. A study performed in Mexico in 2018 by Patricia Pavón-León et al, found results of lower consumption of alcohol and tobacco, with a percentage of 4,4% and 5,5% respectively¹⁸. In another study by Vidal et al in Chile in 2020, it was found that 19,2% of older adults consumed tobacco⁷. The results of smoking among older adults in this study as well as that performed in Chile show a higher prevalence to that reported worldwide, which is 13%¹⁹. We should consider the importance of eliminating bad habits in the entire population, including our patients in rural areas where prevention and promotion strategies were a great tool for avoiding these behaviors.

In this study, 89,2% of older adults consumed soft drinks, these results were similar to that found by Varela, where 78% of older adults consumed industrialized drinks⁸. We should perform a study in our country in which the frequency of drink consumption is evidenced and prove the association to problems of overweight and obesity, and at the same time the appearance of chronic disease and lack of control of these. The consumption of these products, of high sugar and acidifying content, could trigger health problems, which every physician should take into account to promote health behaviors.

CONCLUSIONS

We found some indicators of bad lifestyle, such as alcohol and soft drink consumption, as well as indicators related to bad lifestyle such as the mean of BMI close to overweight, elevated triglycerides and cholesterol levels. We suggest an analytical, prospective study of this population and to carry out lifestyle prevention and promotion strategies in patients of rural zones.