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OBJECTIVE: Poverty generates negative effects on health, education, and family environment. Sectoral analysis through its components enables to identify the risk groups and damage in the families. The objective of this work is to determine the state of poverty and its influence on the risk and family damage in the district of Villa Maria del Triunfo (VMT), Lima, Peru. MATERIALS AND METHODS: Ecological study that used the database of the health facility of the VMT district, in which the family risk and the socioeconomic level of 450 families in 7 sectors are evaluated between the years 2015 to June 2017. RESULTS: More than three-quarters of the families are poor (77.9%). The most prevalent damages were malnutrition and mental health. The most frequent family risk factors were family violence, with the absence of breastfeeding in infants, adolescent pregnancy, and old age. It was found that poverty was associated with family risk (P=.019, OR: 1.84, 95% CI: 1.07-3.23), and damage risk (P<.001, OR: 2.29; 95% CI: 1.32-3.92). CONCLUSION: The level of poverty is high. This condition was associated with increased risk and family damage, especially for malnutrition and mental health problems. Interventions should be carried out in families, especially among the poor, and decisive measures should be made on the social factors determining ill-health.

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Introduction: The diagnosis and treatment of depression in patients with Parkinson's disease (PD) is inadequate, often contributing to a reduced quality of life, rapid disease progression, higher cognitive impairment, and an increased burden of care for family members of patients with PD. Objective: To determine the factors associated with depression in PD and to examine the frequency of depressive symptoms among patients with PD. Methods: This study was an observational, analytical, multicenter study of a cross-sectional cohort, conducted between July 2016 and May 2017. PD patients were recruited from neurology clinics in Lima, Peru. All statistical analyses were performed using descriptive statistics. Bivariate and multivariate logistic regression analyses were calculated using STATA. Results: Out of 124 patients (average age: 68.7 years; 58% males) included in the study 60.5% (75/124) presented with symptoms of depression; only 20% (25/124) received antidepressants. Factors associated with depression in PD included: unemployment, falls, freezing of gait, involuntary movements micrographia, stooped posture, hyposmia, movement disorders in sleep, rapid disease progression, and the use of MAOIs. Furthermore, statistically significant differences were found in disease duration, UPDRS and MMSE scores, Hoehn and Yahr (HY) stage, and length of time taking L-dopa between PD patients with and without depressive symptoms. Conclusion: Factors associated with depressive symptoms in patients with PD were hyposmia, rapid progression of the disease, the use of L-dopa, and use of MAOIs. The frequency of depressive symptoms in patients with PD is high; early diagnosis and prompt treatment are needed to improve their quality of life and the family environment.

Introducción: El diagnóstico y el tratamiento de la depresión en pacientes con enfermedad de Parkinson (EP) son inadecuados, lo que a menudo contribuye a una menor calidad de vida, una rápida progresión de la enfermedad, un mayor deterioro cognitivo y una mayor carga de cuidados para los familiares de los pacientes con EP. Objetivo: Determinar los factores asociados con la depresión en la EP y examinar la frecuencia de los síntomas depresivos entre los pacientes con EP. Métodos: Este estudio fue un estudio observacional, analítico y multicéntrico de una cohorte transversal, realizado entre julio de 2016 y mayo de 2017. Los pacientes con EP fueron reclutados en clínicas de neurología en Lima, Perú. Todos los análisis estadísticos se realizaron utilizando estadísticas descriptivas. Los análisis de regresión logística bivariada y multivariada se calcularon utilizando STATA. Resultados: De 124 pacientes (edad media: 68,7 años; 58% varones) incluidos en el estudio, el 60,5% (75/124) presentó síntomas de depresión; sólo el 20% (25/124) recibió antidepresivos. Los factores asociados a la depresión en la EP incluyeron: desempleo, caídas, congelamiento de la marcha, micrografía de movimientos involuntarios, postura encorvada, hiposmia, trastornos del movimiento durante el sueño, progresión rápida de la enfermedad y el uso de IMAO. Además, se encontraron diferencias estadísticamente significativas en la duración de la enfermedad, puntuaciones UPDRS y MMSE, estadio de Hoehn y Yahr (HY) y tiempo de toma de L-dopa entre pacientes con EP con y sin síntomas depresivos. Conclusión: Los factores asociados a los síntomas depresivos en pacientes con EP fueron la hiposmia, la progresión rápida de la enfermedad, el uso de L-dopa y el uso de IMAO. La frecuencia de síntomas depresivos en pacientes con EP es alta, por lo que se requiere un diagnóstico temprano y un tratamiento oportuno para mejorar su calidad de vida y el entorno familiar.

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