Anxiety and depression are highly prevalent neuropsychiatric conditions and are associated with chronic diseases, pain, loss of autonomy, dependence on others to perform routine activities, and loneliness. Depression often has a cause-and-effect relationship with other diseases, such as: acute myocardial infarction (AMI), systemic arterial hypertension (SAH), diabetes mellitus (DM) and peripheral arterial disease (PAD).To estimate the frequency of anxiety and depression in patients of both sexes with PAD admitted to a tertiary hospital.This is a descriptive, cross-sectional study, with a non-random sample selected consecutively. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression, and the ankle-brachial index (ABI) was used to assess PAD.The prevalence of anxiety in these patients was 24.4%, with associations between anxiety and monthly family income, smoking, and SAH. The prevalence of depression was 27.6%, with associations between depression and the female gender, being married or in a stable relationship, living on a family income of one minimum wage or less, not being an alcoholic, and having hypertension.There are high prevalence rates of anxiety and depressive disorders among patients with PAD, which are underdiagnosed and, hence, not properly treated. Generalized anxiety disorder (GAD) and depressive disorders are prevalent neuropsychiatric conditions that are often associated with chronic diseases, pain, loss of autonomy, dependence on others to perform daily activities, difficulties with interpersonal relationships, and loneliness. They are also correlated with biological risk factors, such as cognitive deficits, systemic arterial hypertension (SAH), chronic diseases, functional limitations, negative health self-perception, use of medications, smoking, and alcoholism.-,,Furthermore, patients who have these associated mental disorders may have worse prognosis of disease chronicity and greater functional compromise, in addition to greater probability of developing cardiovascular diseases (CVD) and suffering strokes. These disorders can therefore be equally important as traditionally recognized risk factors,,According to epidemiological studies, GAD and depression are among the top 10 causes of years lost to incapacity worldwide. Anxiety disorders are ranked ninth in Brazil and fourth worldwide among major causes of incapacity, with a prevalence of 14.9% 13-16.8%) in the global population, which is the equivalent of approximately 270 million people. Depressive disorders are the third-ranked cause of incapacity worldwide and the second in Brazil..8% in th-,Major depressive disorder is the most prevalent, affecting around 350 million people of all ages and both sexes globally and it is associated with a high risk of relapse, occurring in 50% of people who have had a first depressive episode and up to 80% after two episodes.,,,It can be inferred from this bleak situation that treating these serious psychiatric disorders is highly complex and very expensive, particularly when they are concurrent with chronic physical diseases,. Costs are exorbitant because, in addition to the incapacity to work, there are also hidden social security losses and the increased overall spending that these families are subject to.,-Currently, suicide is the second most common cause of death of young adults in the world, with devastating effects for their families and for society.,,,-,,-Depression very often has a cause-consequence relationship with other chronic diseases, such as acute myocardial infarction (AMI), SAH, diabetes mellitus (DM), and cancer, which, in turn, increase the probability of depression.For all of these reasons, it is clearly relevant to conduct a study that documents the associations between anxiety or depression and PAD, since there is a paucity of published data on this correlation. The objective of this study was therefore to estimate the frequency of anxiety and depression among patients of both sexes with PAD admitted to a tertiary hospital in Sergipe and to correlate these data with socioeconomic factors, habits and addictions, intermittent claudication, critical ischemia, chronic diseases, medication, and amputations.This is a descriptive, observational, cross-sectional study conducted at the vascular surgery service of a tertiary hospital with a non-random sample selected consecutively from November 2016 to April 2017. All patients with a diagnosis of PAD admitted to the vascular surgery service for clinical or surgical treatment were recruited. Data collection included administration of a sociodemographic questionnaire (constructed by the researchers) and the Hospital Anxiety and Depression Scale (HADS). The study was approved by the Universidade Federal de Sergipe Research Ethics Committee under hearing number 1.217.875 and all participants signed free and informed consent forms.The ankle-brachial index (ABI) was chosen to assess presence of PAD, because of its well-established diagnostic sensitivity and specificity.Anxiety and depression were assessed using the HADS scale, developed by Zigmond and SnaithPatients’ characteristics were identified using a sociodemographic questionnaire covering items on gender, origin, marital status, religion, educational level, and family income, plus data on prior surgery, continuous use of medication, and comorbidities such as SAH, DM, smoking, and alcoholism.Data were input to spreadsheets and analyzed statistically using SPSS, version 21. The Pearson chi-square test was used to analyze associations between variables and the outcomes anxiety and depression, with 95% confidence interval and p values ≤ 0.05 indicating statistical significance. Next, multivariate analysis with logistic regression was conducted to calculate adjusted and crude odds ratios.A total of 127 patients with a diagnosis of PAD were interviewed. Mean age was 66.4 years (31–91 years) and there was a discrete predominance of male gender (54.3%). The great majority were from provincial areas of the state (66.4%), were married or in stable relationships (56.7%), Catholics (86.6%), with a low level of educational level (26% were illiterate), retired (74%), and were living on a monthly family income less than or equal to the minimum wage (74%) .The prevalence of anxiety among these patients with PAD admitted to the vascular surgery service of a tertiary hospital was 24.4% (31 de 127), with a mean age of 68.33 (±12.09) years. Statistical analysis with the chi-square test identified associations between GAD and monthly family income, smoking, and SAH taking antihypertensive drugs. No associations were identified between any class of antihypertensive and this disorder . These dThe prevalence of depressive disorder in this patient sample was 27.6% (35 out of 127), with a mean age of 69.7 (± 9.8) years. Analysis of the profile of these patients identified significant associations with female gender, stable relationship or marriage, living on the minimum wage or less, not being alcoholic, and being hypertensive. However, there were no significant associations between depression and patient origin, religion, occupational status, regular physical activity, smoking, intermittent claudication, critical ischemia, presence of limb ulcers, use of antihypertensives or hypoglycemics, use of anxiolytics/antidepressants, DM, surgery, and/or amputations .Logistic regression with adjusted likelihood ratios showed that female patients had an approximately 3.7 times greater risk of depression, and those with monthly income less than or equal to the minimum wage had an approximately 3.34 times greater risk. Patients who had undergone some type of amputation were at 2.66 times greater risk of developing this morbidity .,,,Anxiety and depression disorders affect a considerable proportion of patients with chronic comorbidities and cognitive deficits, causing suffering, impaired social relations, and individual physical incapacity. These disorders worsen the prognosis of such comorbidities and increase rates of premature mortality, which can be the result of incapacity or suicide.,,,The prevalence of anxiety in our sample was 24.4%, while the prevalence of depression was 27.6%, with mean ages of 68.33 and 69.7 years, respectively. Elderly women were diagnosed with GAD and with depressive disorder more frequently, as has been detected in some previous studies.,,-,,,-,,Additionally, older patients with comorbidities have more depression and anxiety.,,,,-,,,,Another point that it is indispensable to discuss is that both anxiety and depression are risk factors for CVD, such as AMI, stroke, and PAD.,,,,,,,Emphasizing the importance of our study even further, the literature suggests that there is a robust relationship between depression and PAD,However, there were associations between anxiety or depression and the fact that a patient was surviving on a monthly family income equivalent to or less than the minimum wage. Non-smoking patients had higher frequency of anxiety, as did those taking antihypertensives,,,,,,,,,With regard to depression, the results of the present study were in line with the literature,,To ensure greater reliability of the results observed, those that had p < 0.05 were included in a logistic regression with adjusted odds ratios. In this analysis, in addition to confirming the associations, it was found that women were at an approximately 3.7 times greater risk of depression and those living on a lower monthly income were at a 3.34 times greater risk. In contrast with what had been expected, there was no relationship between a patient being depressive and being employed or not,In relation to those who had undergone an amputation, in this study there was a 2.66 times greater risk of developing depression. This result is in agreement with other studies, which have observed anxiety among these patients, caused by worries about incapacity to perform daily tasks and functional dependence,,Another curious finding was that day-to-day loneliness, such as living alone or not having a partner, did not negatively affect patients’ emotional status, in contrast with what has been described in the literature.It was possible to conclude that there is a high prevalence of GAD and depression among patients with PAD and that these disorders tend to be under-diagnosed and, consequently, are not duly treated. This is possibly dangerous, since these are psychological diseases with the potential for serious secondary risk, primarily because they increase the likelihood of CVD that are very often fatal and because they predispose to suicide. Therefore, health professionals should make greater efforts to identify them early and treat them adequately, providing support to patients and also to their carers. Furthermore, more studies should be conducted to follow larger samples of patients, with longitudinal designs so that it is possible to test whether there are relationships of cause and consequence between these disorders and other comorbidities and whether PAD may be one of the causes of anxiety and depression. This could lead to development of protocols designed to actively screen for these disorders in all affected patients, which would lead to better overall medical care.Based on the results of this study, it was possible to gauge the severity of mental disorders among patients admitted to a tertiary hospital and the extent to which they could have influences on other fatal diseases or lead to people committing suicide. Thus, on the basis of the results observed, it is to be hoped that better care for the mental health of these patients can be provided, with early diagnosis and appropriate treatment not only of the underlying disease, but also of these disorders. Therefore, further studies should be conducted to achieve a better statistical analysis with a larger sample of patients and longitudinal designs in order to make it possible to determine whether there are relationships of cause and consequence between anxiety/depression and the other comorbidities, the medication employed, and socioeconomic variables. Transtorno de ansiedade generalizada (TAG) e transtornos depressivos são afecções neuropsiquiátricas prevalentes que estão comumente associadas a doenças crônicas, dor, perda de autonomia, dependência para realização de atividades rotineiras, dificuldades em relacionamentos interpessoais e solidão. Também se correlacionam a fatores de risco biológicos, tais como comprometimento cognitivo, hipertensão arterial sistêmica (HAS), doenças crônicas, limitações funcionais, autopercepção negativa da saúde, uso de medicações, tabagismo e etilismo-,,Além disso, pacientes com esses transtornos mentais associados podem ter um pior prognóstico de cronicidade da doença e maior comprometimento funcional, bem como maior probabilidade de desenvolver doenças cardiovasculares (DCVs) e acidente vascular encefálico (AVE). Assim, esses transtornos podem se equiparar a fatores de risco tradicionalmente reconhecidos,Segundo estudos epidemiológicos, o TAG e a depressão estão entre as 10 primeiras causas de anos perdidos por incapacidade no mundo. Transtornos de ansiedade ocupam, no mundo e no Brasil, a nona e a quarta posições, respectivamente, entre as principais causas de incapacidade, com uma prevalência de 14,9% 13-16,8%) na população mundial, o que corresponde a aproximadamente 270 milhões de pessoas. Já os transtornos depressivos são a terceira causa de incapacidade em todo o mundo, bem como a segunda causa no Brasil,8% na po-,O transtorno depressivo maior é o mais prevalente, afetando cerca de 350 milhões de pessoas no mundo, em todas as idades e ambos os sexos, e está associado a um alto risco de recaída, que atinge cerca de 50% após o primeiro episódio depressivo e até 80% após dois episódios,,,Infere-se desse contexto sombrio que o tratamento desses distúrbios psiquiátricos graves, principalmente quando em consonância com doenças físicas crônicas, é bastante complexo e oneroso. Os custos são exorbitantes, pois, além da incapacidade laborativa efetiva, há o dano previdenciário oculto e o aumento de gastos gerais para essas famílias,-Atualmente, o suicídio é a segunda causa de morte mais comum entre adultos jovens no mundo, com efeitos devastadores para as famílias e para a sociedade,,,-,,-A depressão, muitas vezes, possui relação de causa-consequência com outras doenças crônicas, como infarto agudo do miocárdio (IAM), HAS, diabetes mellitus (DM) e câncer, os quais, por sua vez, aumentam a probabilidade de depressãoPor tudo isso, justifica-se a relevância de um estudo que documente a associação existente entre ansiedade ou depressão e DAP, visto que há uma escassez de dados na literatura referentes a tal correlação. Dessa forma, o presente estudo teve como objetivo estimar a frequência de ansiedade e de depressão em pacientes de ambos os sexos com DAP, internados em um hospital terciário de Sergipe, e correlacionar esses dados com fatores socioeconômicos, hábitos e vícios, claudicação intermitente, isquemia crítica, doenças crônicas, medicações em uso e amputações.Trata-se de um estudo descritivo, observacional, transversal realizado no serviço de cirurgia vascular de um hospital terciário, com uma amostra não aleatória selecionada de forma consecutiva durante o período de novembro de 2016 a abril de 2017. Foram incluídos todos os pacientes com diagnóstico de DAP internados no serviço de cirurgia vascular para tratamento clínico ou cirúrgico. Para a coleta de dados, foram aplicados um questionário sociodemográfico (confeccionado pelos pesquisadores) e a Escala Hospitalar de Ansiedade e Depressão (HADS). O estudo foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal de Sergipe com o parecer nº 1.217.875, e todos os participantes assinaram o termo de consentimento livre e esclarecido.Para avaliar a presença de DAP, foi eleito o índice tornozelo-braquial (ITB) por sua reconhecida sensibilidade e especificidade no diagnósticoJá para avaliar ansiedade e depressão, foi utilizada a escala HADS, proposta por Zigmond e SnaithPara melhor identificar e caracterizar os pacientes inclusos no estudo, foi aplicado um questionário sociodemográfico com itens relativos a gênero, procedência, estado civil, religião, nível de escolaridade e renda econômica familiar, além de informações sobre cirurgias prévias, uso contínuo de medicações e comorbidades como HAS, DM, tabagismo e etilismo.odds ratio) ajustadas e não ajustadas.Os dados foram organizados em planilhas e analisados estatisticamente com o auxílio do programa SPSS, versão 21. Para análise de associações entre as variáveis e os desfechos ansiedade e depressão, foi utilizado o teste do qui-quadrado de Pearson, com um índice de confiança de 95% e com valores de p ≤ 0,05 estatisticamente significantes. Após, foi feita uma análise multivariada com regressão logística para o cálculo das razões de probabilidade , com um discreto aumento de frequência do sexo masculino . Procediam, em sua grande maioria, do interior do Estado , eram casados ou em união estável , católicos , com baixo nível de escolaridade , aposentados (74%), vivendo com renda familiar mensal igual ou inferior a um salário mínimo (74%) .A prevalência de ansiedade nesses pacientes com DAP internados no serviço de cirurgia vascular do hospital terciário foi de 24,4% (31 de 127), com média de idade de 68,33  anos. A análise estatística com o teste do qui-quadrado mostrou que houve associação entre TAG e renda familiar mensal, tabagismo e HAS em uso de anti-hipertensivos. Não foi demonstrada associação entre quaisquer classes de anti-hipertensivos e esse transtorno . A partiJá a prevalência de transtorno depressivo nos pacientes, por sua vez, foi de 27,6% (35 de 127), com média de idade de 69,7  anos. Com relação ao perfil desses pacientes, verificou-se associação significativa com o sexo feminino, em união estável ou casadas, que sobrevivem com até um salário mínimo, não etilistas e hipertensas. No entanto, não houve associação significativa entre depressão e procedência do paciente, religião, estado ocupacional, prática regular de atividade física, tabagismo, claudicação intermitente, isquemia crítica, presença de úlcera nos membros, uso de anti-hipertensivos ou hipoglicemiantes ou, ainda, ansiolíticos/antidepressivos, DM, cirurgias e/ou amputações .A partir da regressão logística com razão de probabilidade ajustada, foi verificado, ainda, que pacientes do sexo feminino possuem um risco aproximadamente 3,7 vezes maior de desenvolver depressão, e que quem possui uma renda mensal menor ou igual a um salário mínimo tem um risco cerca de 3,34 vezes maior. Em relação aos pacientes que realizaram algum tipo de amputação, há um risco 2,66 vezes maior de desenvolver tal morbidade .,,,Transtornos de ansiedade e de depressão afetam em larga escala pacientes que possuem comorbidades crônicas e deficiências cognitivas, causando sofrimento, redução das relações sociais e incapacidade física do indivíduo. Esses transtornos pioram o prognóstico de tais comorbidades e aumentam as taxas de mortalidade precoce, que pode ocorrer pela própria incapacidade ou pelo suicídio,,,A prevalência de ansiedade em nossa amostra foi de 24,4%, enquanto a de depressão foi de 27,6%, com uma média de idade de 68,33 e 69,7 anos, respectivamente. As mulheres idosas foram mais diagnosticadas com TAG e com transtorno depressivo, assim como foi percebido anteriormente em alguns estudos,,-,,,-,,Além disso, pacientes mais velhos com comorbidades exibem mais depressão e ansiedade,,,,-,,,,Outro ponto imprescindível para discussão é que tanto a ansiedade quanto a depressão são fatores de risco para DCV, como IAM e AVE, e DAP,,,,,,,Enfatizando ainda mais a importância do nosso estudo, a literatura sugere uma forte relação entre depressão e DAPNo entanto, houve associação entre ansiedade ou depressão e o fato de o paciente sobreviver com uma renda mensal familiar equivalente a um salário mínimo ou menos. Pacientes não tabagistas foram mais acometidos pela ansiedade, assim como aqueles que faziam uso de anti-hipertensivos,,,,,,,,Já quanto à depressão, os resultados do presente estudo seguiram a literatura,Para que fosse possível uma segurança maior nos resultados obtidos, foram feitos ajustes naqueles que possuíam p < 0,05 a partir da regressão logística com razões de probabilidade ajustadas. A partir disso, além de terem sido confirmadas as associações, foi verificado, ainda, que as mulheres possuem um risco aproximadamente 3,7 vezes maior de desenvolver depressão, enquanto quem sobrevive com uma renda mensal menor tem um risco 3,34 vezes maior. Ao contrário do que se esperava, não houve relação entre o paciente depressivo e o fato de ser ou não economicamente ativoJá em relação àqueles que realizaram amputação, neste estudo, houve um risco 2,66 vezes maior de desenvolver depressão. Esse resultado está de acordo com os de outros estudos, que constataram ansiedade nesses pacientes, ocasionada por preocupações advindas da incapacidade de realizar tarefas diárias e da dependência funcional,Outro ponto curioso é que a solidão diária, como morar sozinho ou não possuir cônjuge, não afetou negativamente o estado emocional dos pacientes, diferentemente do que foi descrito na literaturaÉ possível perceber que há uma alta prevalência de TGA e depressão entre os pacientes com DAP, e esses transtornos acabam sendo subdiagnosticados e, consequentemente, não são devidamente tratados. Isso é possivelmente perigoso, visto que são doenças psíquicas potencialmente graves quanto aos seus riscos secundários, principalmente por aumentarem as chances de DCV, muitas vezes fatais, e por predisporem ao suicídio. Assim, os profissionais da saúde devem apresentar um maior empenho para identificá-las precocemente e tratá-las adequadamente, oferecendo apoio, inclusive aos cuidadores dos pacientes. Além disso, é preciso que mais estudos sejam desenvolvidos com o intuito de acompanhar uma amostra maior de pacientes em um corte longitudinal, para que seja possível avaliar se há relação causa-consequência entre esses transtornos e as demais comorbidades, e se a DAP pode ser uma das causas da ansiedade e da depressão. Isso pode levar ao desenvolvimento de protocolos que visem a busca ativa desses transtornos em todos os pacientes acometidos, o que levará a uma melhor assistência médica.A partir desse estudo, foi possível perceber a gravidade de transtornos mentais em pacientes internados em um hospital terciário e o quanto esses podem influenciar outras doenças fatais, bem como levar o indivíduo a cometer suicídio. Dessa forma, com base nos resultados obtidos, espera-se que haja uma maior atenção à saúde mental de tais pacientes, com o diagnóstico precoce e o tratamento adequado não só da doença de base como também desses transtornos. Além disso, mais estudos devem ser realizados em prol de uma melhor análise estatística com amostra maior de pacientes e um acompanhamento longitudinal para que seja possível verificar se há relação de causa-consequência entre ansiedade/depressão e as demais comorbidades, as medicações utilizadas e as variáveis socioeconômicas.


Colombian population is getting old in an accelerated manner, causing economic, social and health services effects. The Ministry of Health and Social Protection in the National System of Population Studies and Surveys for Health implemented the first health, well-being and aging survey- SABE-2015 Colombia- to know the living conditions of people 60 years of age or older. Describe the design of the method, statistical sampling and quality control of information from the SABE-2015 survey. A cross-sectional study, with quantitative and qualitative approaches, representative for the population in urban and rural areas aged 60 or over. Information was collected on socioeconomic variables, physical and social environment, behavior, cognition and affection, functionality, mental well-being, health conditions, and the use and access to health services. 23,694 surveys were conducted, 17,189 in urban population (72.5%) and 6,505 in rural population. The percentage of effective national response was 66% in 244 municipalities. Supervision was made in 40% of the surveys and telephone re-contact in 25%. The consistency of 100% surveys was reviewed and double entry was developed in 5% of them. National estimates have a 5% margin error. The SABE Colombia 2015 survey is representative of the main indicators of health, well-being and aging in Colombia. The design allows regional comparisons, between large cities and urban and rural population.  The demographic transition is a process that occurs worldwide. Countries move from a state of high fertility, high mortality and a predominance of a young population to a condition characterized by low fertility, low mortality and the preponderance of an old population. The aging process of the world population is happening faster than in the past. In France it went from 7% to 14% in the population proportion of people over 60 in 115 years, in Brazil, Chile, China and India it was estimated that this process will take a little more than 20 years, and in Colombia only 19 years Consequently, population aging has effects on all sectors of society, including health. In addition to the economic effects associated with changes in labor production and consumption related to this stage of the life course, older adults require more support in health services and care, which creates challenges in disease prevention and in the provision of services. It is a priority to know the living conditions of the elderly (defined as a population over 60 years old) to identify higher risk groups, evaluate and adjust public policies and plan services.Therefore, the Ministry of Health and Social Protection of Colombia, within the National System of Population Studies and Surveys for Health (SNEEPS), set up the development of the Health, Welfare and Aging Survey (SABE-Colombia)More specifically, from a life course approach, and taking into account the structural and intermediary social determinants that generate health inequities, SABE evaluated different dimensions included in the policy framework of Active Aging, as it is represented in The objective of this article was to describe in detail the methodological design of the survey, including aspects of the statistical sample for the estimation of parameters, the procedures for the collection of information, and the tools for quality assurance and quality control.The SABE survey is a cross-sectional study with a quantitative and qualitative methodological approach, representative for the population of men and women 60 years of age or older in the country. In the development of the quantitative component, the study included the application of the following components:1. A population household survey in urban and rural areas of Colombia, which recorded general information about older adults in relation to socioeconomic variables, physical and social environment, behavior, cognition and affection, functionality, mental well-being, medical and health conditions, and the use and access to health services.2. Anthropometric measures to all individuals participating in the population survey. These measurements included weight, height, waist circumference, calf circumference, arm circumference, and knee height.3. Determination of glucose levels, lipid profile and hemoglobin by taking blood samples, in two out of five individuals included in the population survey.4. Blood pressure measurement in a subsample of older adults participating in the survey.5. Functionality tests in a subsample of older adults including grip strength, walking speed, balance and time to get up from a chair.The qualitative component was carried out under an interpretive-comprehensive approach with a focus on symbolic interactionism, which was oriented towards interactions, the dynamics of social activities among people, the meanings attributed to events, the natural environments in which they live, and the actions they perform The universe of the study was composed of the population residing in urban and rural households in all regions of Colombia ; and the target population was all adults 60 years of age and older, non-institutionalized and Spanish speakers. The final sample was composed of those individuals residing in the municipalities randomly selected by region and from cities with a population of over 1.2 million inhabitants . For the sampling frame, the mapping of blocks and units of SNEEPS was used, taking into account the classification by municipalities, urban or rural areas .The geographical coverage of the survey was national, with disaggregation by six major regions: Atlantic, Eastern, Bogotá, Central, Pacific and Orinoquia-Amazonia; large cities and urban-rural stratification . The colThe adaptation and adjustment of the sample design for the SABE Colombia Survey was based on the guidelines set forth by SNEEPS, of the Ministry of Health and Social Protection, which considers the implementation and development of a master sample of households for population studies in health The calculation of the sample was carried out taking into account the regional disaggregation and the forced inclusion of the four large cities. The sample size for these cities, 3,500 individuals per city, was added to the national value by accumulating the sample values for the sub region, region and country. The formulas used corresponded to a simple random sampling, adapted to the cluster design according to Leslie Kish N is the population size, P is the expected minimum prevalence, Q is the complement to the prevalence, Deff is the design effect due to the conglomeration of units and Esrel the relative error. Where According to the previous description, 30,691 surveys were estimated at the national level, 23,162 in the urban area (75.5%) and 7,529 in the rural area . A total of 6,530 segments, 4,928 urban and 1,602 rural, were planned to obtain the surveys, with an expected average of 4.7 adults per segment.For this subsample, the calculation of the sample size was carried out taking into account national representation. 86 municipalities were selected, including the 4 large cities. The same formula as for the general sampling was used, assuming an expected proportion of 0.07, a design effect of 1.2, a relative standard error of 0.065 and a non-response percentage of 20%. Obtaining a sample of 4,525 people 60 years of age or older.The selection of older adults was carried out using systematic sampling, by randomly selecting two out of five individuals of the general sample.Based on the same selection of the 86 municipalities for the biomarker subsample, the selection was made for the application of functionality tests and blood pressure assessment in the elderly population. The estimate took into account an expected proportion of approximately 6%, a maximum error of 6% and a non-response percentage of 20%. The sample obtained was 6,161 people with national representation. The selection was done systematically, with a general periodic inclusion of one for every two individuals of the survey.For this subsample, convenience sampling was carried out among people residing in households who help to carry out the activities of daily living for adults 60 years of age or older selected in the survey sample. No selection scheme was used; but only those caregivers who agreed to participate in the different municipalities selected in the general sample. The estimated sample was 1,000 people with national representation. Several sampling strategies were carried out in the qualitative component: geographical, for the convenience of the selection of cities and towns based on ethnographic criteria; and cultural with a classification of the five regions of Colombia; from each region two municipalities were selected for convenience. For the interviews, a sampling of cases of maximum variation was used For the focus groups, the call process was established through the sampling of homogeneous cases, with the inclusion criteria as belonging to older adults social groups, a minimum of one year of membership, and diversity in terms of sex and age.For the construction of statistical estimators of the parameters of interest and according to the sampling stages, the estimator of the total of the variable was be given by hijk represents the final expansion factor of the person from the k-th household, the jth USM, the i-th city, the h-th stratum  and Xhijk in the same way, the value associated with the characteristic of interest for each adult of 60 years or more observed. The estimation of proportions and reasons were obtained by the following expression:Where: FWhere each element in the quotient represents a total of one characteristic of interest.For the evaluation of sampling errors of national estimates, the Last Cluster Method was used The information was collected through two processes and consecutively: the segmentation and the application of surveys and subsamples. The segmentation process required a previous review of the cartography delivered and the field survey of the segments for each block. In this process, the fieldworker carried out the recognition and count of the dwellings, for which they took into account the norms established in the manual of lifting and segmentation of the Master Sample of Homes designed for the study in Health, and also identified homes with potential participants for the survey. For the application of the surveys, only the segments allowed by the Ministry of Health for each block were taken.The SABE survey was applied through a face-to-face interview, using a structured questionnaire with 13 sections: Identification and filter, socioeconomic aspects, physical environment, social environment, behavior, cognition and affection, functionality, medical and health conditions, use and access to health services, anthropometry and functional assessment, link to subsample, subsample record and control data The interviewers visited the homes previously selected in the segmentation process, each carrying elements of study identification. The application of the survey involved the identification of the participants, the registration of demographic data, the signing of informed consent, application of the selection criteria and application of filters through the abbreviated Folstein Mini Mental Test. For older adults, where the score obtained by the test was below 13 points the questions were answered by a companion -proxy-; In this case, the consent of the proxy and the consent of the elderly were diluted.The anthropometric measurements were taken at the end of the completion of the survey, as well as the functionality tests and blood pressure taking, in the case of having been systematically selected. For the sub-sample of biomarkers, the citation was given to the selected persons, for later taking. For the recording of information, mobile and paper capture devices were used.All fieldwork personnel were trained for the segmentation process, the application of the survey and the taking of the subsamples. Professionals conducted the training by using strategies such as master classes, individual and group workshops, field activities and sessions to solve questions.The pilot test was carried out in two urban areas (Bogotá and Ubaté) and one rural area (Soledad), located in two regions defined for the collection of the sample. The objective of the test was to evaluate the operationalization of the field work in terms of time, cost, procedures, instruments and adverse events to the different procedures.This test allowed evaluating the operation of the field survey, the degree of understanding of the questionnaires by the interviewees, the taking of anthropometric measurements, application of functionality tests and biomarkers sampling. On the other hand, the data management process, the capture, the web transmission to the server and the quality control process were also evaluated.For the biomarker subsample, a pilot test was also carried out in four municipalities in the department of the Valle del Cauca: Cali, Palmira, Candelaria, and Guacarí. This pilot test allowed to review the procedures for a better planning of the field work, specifically related to the selection of the participants, the communication mechanisms, baseline requirements for the sampling, the appointment scheduling process through the call center, transportation and travel scheme, the conditions and measures of biosecurity of technicians and training for the processing of informed consent. Likewise, the formats and manuals of the pre-analytical, sample collection, packaging, transfer and temporary storage of samples based on quality standards were validated.Qualitative data was recorded through a semi-structured interview, observation and focus groups. Each interview followed a guide to ensure obtaining information on the same topics and the same density among participants. All data were recorded and transcribedIn order to ensure the quality of the data, audit processes and supervision of the survey procedures were designed and implemented. Through the audit, a systematic, independent and documented process of verification of adherence to field staff procedures, information collection procedures, anthropometric measurement protocols, functionality and blood pressure was performed. The audit team was made up of a general coordinator, 5 supervisors and 15 auditors. The audit intervention was effective during the application of the survey ensuring the correct completion of the survey, the informed consent or the processes related to the subsamples.Likewise, there was another supervisory team in the field, who accompanied the interviewer teams and reported to the regional coordinators, a national coordinator and a central technical area. In this process, the concerns and questions of the segmentation activities, the application of the survey and the subsamples were answered. The monitoring process was developed in 40% of all surveys and telephone or face-to-face contact was made in at least 25% of the surveys.In parallel, a technical monitoring committee at the central level carried out the monitoring of field work performance. The calculation of indicators was carried out through the information filled out by the supervisors. Some of the most relevant indicators were: housing coverage, percentage of effective response, percentage of rejections, percentage of momentary and permanent absence, number of adults 60 years or older by segment and number of re-visits.All information resulting from the audit process  and supervision was recorded weekly in an online information system with the objective of supporting decision making by supervisors and the coordinator, in addition to feedback processes field work. This system allowed the generation and consultation of the information for the weekly analysis by the technical monitoring committee. For this process, restricted permits were used according to the type of user .On the other hand, the information quality control process had several stages; initially the field supervision process reviewed questionnaire jumps and questions without data, then at the central level a telephone contact was made with 10% of the respondents selected at random, for the corroboration of the data. The subsequent stage was coding and criticism, for which a group of people reviewed the consistency of 100% of the surveys and assigned codes for digitization, in addition the surveys were organized in packages. Finally, in the digitization stage each package was systematized and duplication was performed with 5% of the surveys.The data analysis was carried out taking into account the disaggregation established in the sample design. As they are: national level, urban-rural area and six large regions. For the estimation of the parameters, the expansion factor calibrated according to the population distribution of the DANE 2015 projections was used in the variables: region, sex, age ranges (five-year periods) and urban-rural; this in order to adjust the differences between the distribution of the planned sample and that obtained in the aforementioned variables. It is important to keep in mind that for the study of the variables with prevalence below 0.03 or of the variables different from those mentioned in the adjustment of the factor, the coefficients of variation should be reviewed considering less precise the estimates with coefficients greater than 20% All analyses were performed using the sample design declaration and weighting with the expansion factor in the Stata 14 software This study was approved by the Human Ethics Committee of the Faculty of Health of Universidad del Valle (Acts No. 09-014 and 011-015) and the Bioethics Committee of the Universidad de Caldas (code CBCS-021-14).The field work for the sample collection was carried out in 29 weeks. A total of 36,153 older adults were found, of these 23,694 surveys were carried out, for a percentage of national effective response of 66% in 244 municipalities . From th Were worked 8,696 segments, finding a general average of 4.2 adults 60 years of age or older per segment, with variations by region. Regarding the rejections and non-recoverable absences, the general result was 28% and 6% respectively, with differentials by region, where Bogotá presented the highest percentage of rejections (51%). .Regarding the subsamples, in biomarkers there was a final sample of 4,092; for blood pressure, 5,106 measurements; for functionality tests, 4,362 chair tests and 4,831 grip strength; and among caregivers, 1,141 surveys. In the distribution by sex of the general sample there was a higher frequency of women (57.3%), also in the regions, the highest proportion was collected in the Orinoquía and Amazonia (61.2%). By age groups, the highest proportion of surveys were conducted in people between 60 and 64 years (27.7%), in this group 72.7% belonged to the urban area and 58% were women ..The SABE Colombia survey, maintaining coherence with many of the components of the original SABE, proposed a conceptual framework from which progress was made in the definition of different dimensions of analysis. Consistent with that framework, the results are primarily intended to characterize unfair inequalities in the living conditions of older adults in order to contribute to decision making.In general, population health surveys are instruments for analyzing the living conditions and well-being of the population that serve to characterize inequities in order to prioritize groups and define or adjust action strategies, programs and public policies.The results must therefore be reliable and the role of quality control in each phase of the survey protocol is to ensure that the data is obtained in a way that represents the population, that the indicators are free of bias and that the Accuracy of the estimates is necessary to establish comparisons between interest groups. This was the first of the national health surveys to make use of the master sample prepared for the 2013-2023 period, which confers additional advantages to this study within the National Survey System. In addition to reducing the costs of preparation and sampling work, this unique sampling framework follows standardized parameters that favor national representation and geographical subdivisions and will facilitate comparability between different populations studied and with future studies. It is possible that from now on, surveys with panel methodology may also be plannedThe quality assurance and control processes were carried out permanently and under the supervision and audit of a team of trained professionals during and after the field work. An online information system allowed team members to monitor the work of survey teams and field supervisors, identify early alerts and define actions to follow. In periodic meetings, it was possible to discuss with all stakeholders the progress and difficulties in making decisions about field work.Despite all the procedures carried out and the rigor that was taken in the various phases of design and development of the Survey, one of the biggest challenges was the achievement of a percentage of response according to the standard values accepted in population sampling. Many surveys worldwide are experiencing increasing percentages of non-response and, although this does not necessarily mean the occurrence of bias or alteration in the estimation of indicators, the most common prescription for the development of population surveys is to minimize non-response There are, however, no single accepted values of percent response in the literature. According to Babbie Additionally, the SABE Colombia survey included a qualitative component that complements several of the findings of the quantitative component and contributes to the analysis of the conditions of the elderly population of Colombia through data triangulation approaches. La transición demográfica es un proceso que ocurre a nivel mundial. Los países pasan de un estado de alta fertilidad, alta mortalidad y predominio de una población joven a una condición caracterizada por la baja fertilidad, baja mortalidad y la preponderancia de una población vieja. El proceso de envejecimiento de la población mundial está ocurriendo más rápidamente que en el pasado. En Francia pasó del 7% al 14% en la proporción poblacional de personas mayores de 60 años en 115 años, en Brasil, Chile, China y la India se estimó que este proceso tomará un poco más de 20 años y en Colombia en solo 19 años En consecuencia, el envejecimiento poblacional tiene efectos en todos los sectores de la sociedad, incluyendo la salud. Además de los efectos económicos asociados a los cambios en la producción laboral y el consumo relacionados con esta etapa del curso de vida, las personas adultas mayores requieren más soporte en cuidados y en atención en salud lo que genera retos en la prevención de enfermedad y en la provisión de servicios. Es prioritario conocer las condiciones de vida de las personas adultas mayores (definida como población mayor de 60 años) para identificar grupos de mayor riesgo, evaluar y ajustar políticas públicas y planificar servicios.En consecuencia, el Ministerio de Salud y Protección Social de Colombia estableció, dentro del Sistema Nacional de Estudios y Encuestas Poblacionales para la Salud (SNEEPS), desarrollar la Encuesta de Salud, Bienestar y Envejecimiento (SABE-Colombia) Más específicamente, desde una aproximación de curso o trayectorias de vida y teniendo en cuenta los determinantes sociales estructurales e intermediarios que generan las reconocidas inequidades en salud, la SABE evaluó las diferentes dimensiones del marco de la política de los determinantes del envejecimiento activo, tal como se representa en la El objetivo de este artículo fue describir en detalle el diseño metodológico de la encuesta, incluyendo aspectos de la muestra estadística para la estimación de parámetros, los procedimientos para la recolección de la información, los mecanismos para aseguramiento y control de calidad.La encuesta SABE es un estudio de corte transversal, con un enfoque metodológico cuantitativo y cualitativo, representativo para la población de hombres y mujeres de 60 años o más en el país. En el desarrollo del componente cuantitativo de este estudio se incluyó la aplicación de: 1. Encuesta poblacional en hogares de zonas urbanas y rurales de Colombia, que registró información general de personas adultas mayores en relación con variables socioeconómicas, del entorno físico y social, de la conducta, la cognición y el afecto, la funcionalidad, el bienestar mental, las condiciones médicas y de salud, y el uso y acceso a servicios de salud. 2. Determinación de los niveles de glucosa, perfil lipídico y hemoglobina mediante la toma de muestras de sangre, realizadas en dos de cada cinco personas incluidas en la encuesta poblacional. 3.Toma de medidas antropométricas a la totalidad de las personas adultas mayores participantes en la encuesta poblacional. Estas medidas incluyen peso, talla, circunferencia de cintura, circunferencia de pantorrilla, circunferencia del brazo y la altura de rodilla. 4.Submuestra de presión arterial, aplicada de manera efectiva a las personas adultas mayores del país, participantes en la encuesta. 5. Submuestra de pruebas de funcionalidad como fuerza de agarre, velocidad de la marcha, equilibrio y tiempo de incorporarse de una silla. El componente cualitativo se realizó bajo una mirada interpretativa-comprensiva con un enfoque de interaccionismo simbólico, orientado a las interacciones, la dinámica de las actividades sociales entre las personas, los significados que atribuyen a los eventos, los ambientes naturales en que viven y las acciones que desempeñan El universo del estudio estuvo compuesto por la población residentes en hogares urbanos y rurales de todas las regiones de Colombia ; La población objetivo fueron todos los adultos de 60 años y más, no institucionalizados, de habla hispana y finalmente la muestra estuvo compuesta por aquellos adultos mayores residentes en los municipios seleccionados aleatoriamente por cada región y de las grandes ciudades  con población superior a 1.2 millones de habitantes. Para el marco muestral se utilizó la cartografía de manzanas y unidades del SNEEPS, teniendo en cuenta la clasificación por municipios, zonas urbanas o rurales .La cobertura geográfica de la encuesta fue nacional, con desagregación de seis grandes regiones como Atlántica, Oriental, Bogotá, Central, Pacífica y Orinoquía-Amazonía, grandes ciudades y estratificación urbano-rural . El periLa adaptación y ajuste del diseño muestral para la Encuesta SABE Colombia se basó en los lineamientos dispuestos por el SNEEPS, del Ministerio de Salud y Protección social, que considera la implementación y desarrollo de una muestra maestra de hogares para estudios poblacionales en salud El cálculo de la muestra se realizó teniendo en cuenta la desagregación regional y la inclusión forzosa de las cuatro grandes ciudades. El tamaño de la muestra para estas ciudades se adicionó al valor nacional al acumular los valores muestrales para subregión, región y país, este se fijó en 3,500 adultos mayores en cada ciudad. Las fórmulas utilizadas correspondieron a un muestreo aleatorio simple, adaptadas al diseño de conglomerados de acuerdo con Leslie Kish N es el tamaño poblacional, P es la prevalencia mínima esperada, Q es el complemento de la prevalencia, Deff es el efecto de diseño debido a la conglomeración de unidades y Esrel el error relativo. Donde De acuerdo con el esquema anterior se obtuvieron 30,691 encuestas esperadas a nivel nacional, 23,162 en la zona urbana (75.5%) y 7,529 en la zona rural . Se planearon 6,530 segmentos, 4,928 urbanos y 1,602 rurales para la obtención de las encuestas, teniendo en cuenta un promedio de 4.7 adultos por segmento.Para esta submuestra el cálculo del tamaño muestral se realizó teniendo en cuenta representatividad nacional. Se seleccionaron 86 municipios, incluyendo las 4 grandes ciudades. Se utilizó la misma fórmula de la muestra general, asumiendo una proporción esperada de 0.07, un efecto de diseño de 1.2, un error estándar relativo de 0.065 y un porcentaje de no respuesta del 20%. Obteniendo una muestra de 4,525 personas de 60 años o más.La selección de los adultos mayores se realizó de forma sistemática, calculando un salto muestral de acuerdo a la muestra general en cada municipio seleccionado, en este caso, dos de cada cinco personas.Con base en la misma selección de los 86 municipios para la submuestra de biomarcadores, se realizó la selección para la aplicación de pruebas de funcionalidad y valoración de la presión arterial en la población adulta mayor. La estimación tuvo en cuenta una proporción esperada aproximada de 6%, un error máximo de 6% y un porcentaje de no respuesta de 20%. La muestra obtenida fue de 6,161 personas con representatividad nacional. La selección se realizó de forma sistemática, con un salto general de uno por cada dos adultos mayores de 60 años de la encuesta. Para esta submuestra se realizó un muestreo a conveniencia sobre personas residentes en hogares que ayudan a realizar las actividades de la vida diaria a los adultos de 60 años o más seleccionados en la muestra de la encuesta. No se utilizó esquema de selección, sólo aquellos cuidadores que aceptaran participar en los diferentes municipios seleccionados en la muestra general. La muestra estimada fue de 1,000 personas con representatividad nacional.Se llevaron a cabo varios tipos de muestreo: geográfico, por conveniencia para la selección de ciudades y pueblos basados en el criterio etnográfico, y cultural con una clasificación de las cinco regiones de Colombia; de cada una se seleccionaron dos municipios por conveniencia. Para las entrevistas se utilizó un muestreo de casos de variación máxima Para los grupos focales, el proceso de convocatoria se estableció a través del muestreo de casos homogéneos teniendo como criterios de inclusión pertenecer a grupos de socialización de adultos mayores, con mínimo un año de pertenencia al mismo, diverso en cuanto a sexo y edad.Para la construcción de estimadores estadísticos de los parámetros de interés y conforme las etapas de muestreo, el estimador del total de la variable estará dado porhijk representa el factor final de expansión de la persona del k-ésimo hogar, de la j-ésima USM, de la i-ésima ciudad, del h-ésimo estrato  y Xhijk de la misma forma, el valor asociado a la característica de interés para cada adulto de 60 años o más observado. La estimación de proporciones y razones se obtienen mediante la siguiente expresión:Donde: FDonde cada elemento en el cociente representa un total de una característica de interés.Para la evaluación de los errores de muestreo de las estimaciones nacionales se utilizó el método de Conglomerados Últimos La recolección de la información se realizó a través de dos procesos y de forma consecutiva: la segmentación y la aplicación de encuestas y submuestras. El proceso de segmentación requirió una revisión previa de la cartografía entregada y el levantamiento en campo de los segmentos por cada manzana. En este proceso el segmentador realizó el reconocimiento de las viviendas y su recuento, para la cual tuvo en cuenta las normas establecidas en el manual de levantamiento y segmentación de la Muestra Maestra de Hogares diseñado para el estudio en Salud, además se incluyó la identificación de las viviendas con potenciales participantes para la encuesta. Para la aplicación de las encuestas sólo se tomaron los segmentos permitidos por el Ministerio de Salud por cada manzana.La encuesta SABE se aplicó a través de una entrevista cara a cara, utilizando un cuestionario estructurado con 13 secciones: Identificación y filtro, aspectos socioeconómicos, medio ambiente físico, medio ambiente social, conducta, cognición y afecto, funcionalidad, condiciones médicas y de salud, uso y acceso a servicios de salud, antropometría y valoración funcional, enlace a submuestra. registro submuestra y datos de control Los encuestadores visitaron los hogares seleccionados previamente en el proceso de segmentación, portando cada uno elementos de identificación del estudio. La aplicación de la encuesta implicó la identificación de las personas participantes, el registro de los datos demográficos, la firma del consentimiento informado, aplicación de los criterios de selección y aplicación de los filtros a través del Minimental Test de Folstein abreviado. Para los adultos mayores, donde el puntaje obtenido por el test estuvo por debajo de 13 puntos las preguntas fueron respondidas por un acompañante -proxy-; en este caso se diligenció el consentimiento del proxy y el asentimiento del adulto mayor.La toma de las medidas antropométricas se realizó al final del diligenciamiento de la encuesta, así como las pruebas de funcionalidad y la toma de la presión arterial, en el caso de haber sido seleccionado sistemáticamente. Para la submuestra de biomarcadores se entregó la citación a las personas seleccionadas, para su posterior toma. Para el registro de la información se utilizaron dispositivos móviles de captura y en papel.Todo el personal de trabajo de campo fue capacitado para el proceso de segmentación, la aplicación de la encuesta y la toma de las submuestras. El entrenamiento fue realizado por profesionales utilizando estrategias como clases magistrales, talleres individuales y grupales, actividades en campo y sesión de preguntas.La prueba piloto se realizó en dos zonas urbanas (Bogotá y Ubaté) y una zona rural (Soledad), ubicadas en dos regiones definidas para la recolección de la muestra. El objetivo de la prueba fue evaluar la operativización del trabajo de campo en términos de tiempo, costo, procedimientos, instrumentos y eventos adversos a los diferentes procesos.Esta prueba permitió evaluar el funcionamiento de la encuesta en campo, el grado de comprensión de los cuestionarios por parte de los entrevistados, la toma de mediciones antropométricas, de biomarcadores y las pruebas de funcionalidad. Por otro lado, también fueron evaluados los procesos de administración de datos, la captura, la transmisión vía web al servidor y el proceso de control de calidad. Para la submuestra de biomarcadores también se realizó una prueba piloto en cuatro municipios del departamento del valle del cauca: Cali, Palmira, Candelaria, y Guacarí. Esta prueba piloto permitió revisar los procedimientos para una mejor planeación del trabajo de campo, específicamente lo relacionado con la selección de los participantes, los mecanismos de comunicación, requisitos basales para la toma de la muestra, el proceso de programación de citas a través de la central de llamadas, esquema de transporte y desplazamiento, las condiciones y medidas de bioseguridad de los técnicos y el entrenamiento para el diligenciamiento del consentimiento informado. Así mismo, se validaron los formatos y manuales de las etapas de preanalítica, de toma de las muestras, embalaje, traslado y el almacenamiento temporal de las muestras con base en los estándares de calidad.El registro de datos cualitativos se realizó a través de una entrevista semiestructurada, la observación y el grupo focal. Cada entrevista siguió una guía para garantizar la obtención de información sobre los mismos temas y de la misma densidad entre participantes. Todos los datos fueron grabados y transcritos textualmente Para el aseguramiento de la calidad de los datos se diseñaron e implementaron procesos de auditoría y supervisión de los procedimientos de la encuesta. A través de la auditoría se realizó un proceso sistemático, independiente y documentado de verificación de la adherencia a los procedimientos del personal de campo, procedimientos de recolección de información, protocolos de toma de medidas antropométricas, de funcionalidad y presión arterial. El equipo de auditoría estuvo conformado por un coordinador general, 5 supervisores y 15 auditores. La intervención de la auditoria se hizo efectiva durante la aplicación de la encuesta asegurando el correcto diligenciamiento de la encuesta, el consentimiento informado o de los procesos relacionados con las submuestras.Así mismo, se contó con otro equipo de supervisión en campo, los cuales acompañaron a los equipos de encuestadores y reportaron a los coordinadores regionales, a un coordinador nacional y a una área técnica central. En este proceso se dió respuesta a las inquietudes y las preguntas de las actividades de segmentación, a la aplicación de la encuesta y de las submuestras. El proceso de supervisión se desarrolló en el 40% de todas las encuestas y se realizó re-contacto telefónico o presencial en al menos el 25% de las encuestas.De forma paralela, se llevó a cabo el seguimiento al desempeño del trabajo de campo a nivel central, por parte del comité técnico de seguimiento. Se realizó el cálculo de indicadores a través de la información diligenciada por parte de los supervisores. Algunos de los indicadores más relevantes fueron: cobertura de viviendas, porcentaje de respuesta efectiva, porcentaje de rechazos, porcentaje de ausencia momentáneas y permanentes, número de adultos de 60 años o más por segmento y número de re-visitas.Toda la información producto del proceso de auditoría  y supervisión se registró semanalmente en un sistema de información en línea con el objetivo de apoyar la toma de decisiones por parte de los supervisores y del coordinador, además retroalimentar los procesos del trabajo del campo. Este sistema permitió la generación y consulta de la información para el análisis semanal por parte del comité técnico de seguimiento. Para este proceso se utilizaron permisos restringidos de acuerdo con el tipo de usuario .Por otro lado, el proceso del control de la calidad de la información contó con varias etapas; inicialmente el proceso de supervisión en campo revisaba saltos y preguntas sin dato, luego al nivel central se realizó un contacto telefónico con el 10% de los encuestados seleccionadas al azar, para la corroboración de los datos. La etapa posterior fue la codificación y crítica, para la cual un grupo de personas revisaron la consistencia del 100% de las encuestas y asignaron códigos para la digitalización, además se organizaron las encuesas en paquetes. Finalmente, en la etapa de digitalización cada paquete fue sistematizado y se realizó doble digitación con el 5% de las encuestas.El análisis de los datos se realizó teniendo en cuenta las desagregaciones establecidas en el diseño muestral. Como son: nivel nacional, zona urbano-rural y seis grandes regiones. Para la estimación de los parámetros se utilizó el factor de expansión calibrado de acuerdo con la distribución poblacional de las proyecciones del DANE 2015 en las variables: región, sexo, rangos de edad (quinquenios) y urbano-rural; Esto con el objetivo de ajustar las diferencias entre la distribución de la muestra planeada y la obtenida en las variables antes mencionadas. Es importante tener en cuenta que para el estudio de las variables con prevalencias por debajo de 0.03 o de las variables diferentes a las mencionadas en el ajuste del factor, se deben revisar los coeficientes de variación considerando las estimaciones con coeficientes mayores al 20% como poco precisas Todos los análisis se realizaron utilizando la declaración del diseño muestral y la ponderación con el factor de expansión en el software Stata 14 Este estudio contó con el aval del comité de ética Humana de la facultad de Salud de la Universidad del Valle (actas No. 09-014 y 011-015) y del comité de Bioética de la Universidad de Caldas (código CBCS-021-14).El trabajo de campo para la recolección de la muestra se realizó en 29 semanas. Se encontraron 36,153 personas adultas mayores, de estas se lograron realizar 23,694 encuestas, para un porcentaje de respuesta efectiva nacional del 66% en 244 municipios . Del totSe trabajaron 8,696 segmentos, encontrando un promedio general de 4.2 personas adultas de 60 años o más por segmento, con variaciones por región. Respecto a los rechazos y ausencias no recuperables, el resultado general fue del 28% y 6% respectivamente, con diferenciales por región, donde Bogotá presentó el porcentaje más alto de rechazos (51%). Respecto a las submuestras, biomarcadores se tuvo una muestra final de 4,092, presión arterial 5,106, pruebas de funcionalidad  y cuidador con 1,141 encuestas. En la distribución por sexo de la muestra general se presentó mayor frecuencia de mujeres (57.3%), así mismo en las regiones, la mayor proporción se recolectó en la Orinoquía y Amazonía (61.2%). Por grupos de edad, la mayor proporción de encuestas se realizó en personas entre 60 y 64 años (27.7%), en este grupo 72.7% perteneciann a la zona urbana y 58% fueron mujeres ..La encuesta SABE Colombia, manteniendo coherencia con muchos de los componentes de la SABE original, propuso un marco conceptual desde el que se avanzó en la definición de diferentes dimensiones de análisis. En coherencia con ese marco, los resultados tienen como principal propósito caracterizar las desigualdades injustas en las condiciones de vida de las personas adultas mayores con el fin de aportar a la toma de decisiones. En general, las encuestas poblacionales en salud son instrumentos de análisis de las condiciones de vida y bienestar de la población que sirven para caracterizar las inequidades con el propósito de priorizar grupos y definir o ajustar estrategias de acción, programas y políticas públicas.Los resultados deben por tanto ser confiables y el papel del control de calidad en cada una de las fases del protocolo de la encuesta es asegurar que los datos sean obtenidos de manera que representen a la población, que los indicadores estén libres de sesgos y que la precisión de las estimaciones sea la necesaria para establecer comparaciones entre grupos de interés. Fue esta la primera de las encuestas nacionales en salud en hacer uso de la muestra maestra elaborada para el periodo 2013-2023, lo cual confiere ventajas adicionales a este estudio dentro del Sistema Nacional de Encuestas. Además de la reducción de costos de preparación y de trabajo de muestreo, este marco muestral único sigue unos parámetros estandarizados que favorecen la representatividad nacional y por subdivisiones geográficas y facilitarán la comparabilidad entre diferentes poblaciones estudiadas y con futuros estudios. Es posible que en adelante puedan planificarse además encuestas con metodología panel Los procesos de aseguramiento y control de calidad se llevaron a cabo de manera permanente y bajo la supervisión y auditoría de un equipo de profesionales entrenados durante y después del trabajo de campo. Un sistema de información en línea permitía a los miembros del equipo hacer seguimiento al trabajo de los equipos de encuestadores y supervisores en campo, identificar tempranamente alertas y definir acciones a seguir. En reuniones periódicas se pudieron discutir con todos los interesados los avances y dificultades para la toma de decisiones sobre el trabajo de campo.A pesar de todos los procedimientos llevados a cabo y de la rigurosidad que se tuvo en las diversas fases de diseño y desarrollo de la Encuesta, uno de los mayores retos fue el logro de un porcentaje de respuesta acorde con los valores estándar aceptados en muestreos poblacionales. Muchas encuestas a nivel mundial están experimentando porcentajes de no respuesta crecientes y, aunque esto no necesariamente significa la ocurrencia de sesgo ni alteración en la estimación de los indicadores, la prescripción más común para el desarrollo de encuestas poblacionales es minimizar la no respuesta No hay sin embargo valores únicos aceptados de porcentaje de respuesta en la literatura. De acuerdo a Babbie Adicionalmente, la encuesta SABE Colombia incluyó un componente cualitativo que complementa varios de los hallazgos del componente cuantitativo y aporta al análisis de las condiciones de la población adulta mayor de Colombia mediante aproximaciones de triangulación de datos.


Syringomas are benign tumors of cutaneous appendages of eccrine or apocrine origin affecting approximately 1% of the population. They mainly occur in women and they commonly manifest as soft skin-colored or slightly yellowish papules on the lower eyelid and the upper part of the cheeks. More rarely, syringomas can even occur on the neck, the armpits, the breasts, the lower portion of the abdomen, the thighs and the groin. Clinically, they can be distinguished from xanthelasmas, warts or cancers because they are monomorphic and have a regular distribution. In doubtful cases, the diagnosis is confirmed by biopsy. Syringomas can be easily detected on histological examination due to the presence of comma-shaped sweat ducts in the dermis. Even though syringomas are benign tumors, their appearance can be embarrassing to the patients. Therapeutic options, mainly supported by small case series and case reports, include surgical excision, electrodessication, curettage, chemical exfoliation, cryosurgery and laser treatment. However, as these tumors lie deep in the dermis, all treatments are associated with a substantial risk of recurrence and can cause scars and skin pigment changes. We here report the case of a 40-year old woman with no previous history, presenting with skin-colored periorbital papules whose histological examination showed syringomas. Les syringomes sont des tumeurs bénignes des annexes cutanées qui tireraient leur origine des canaux exocrines ou apocrines et qui affectent environ 1% de la population. Ils s'observent le plus souvent chez les femmes et prennent généralement la forme de papules molles de couleur chair ou légèrement jaunâtres à la paupière inférieure et à la partie supérieure des joues. Plus rarement, les syringomes s'observent ailleurs qu'au pourtour des yeux, soit au cou, aux aisselles, aux seins, à la portion inférieure de l'abdomen, aux cuisses et à l'aine. Au plan clinique, les syringomes se distinguent des xanthélasmas, des verrues ou des cancers par leur caractère monomorphe et leur distribution régulière; le diagnostic est confirmé par biopsie dans les cas douteux. À l'examen histologique, les syringomes se reconnaissent facilement par la présence de canaux sudoripares ayant la forme de virgules dans le derme. Même si les syringomes sont bénins, leur apparence peut être gênante pour les patients. Les options thérapeutiques, étayées pour la plupart par de petites séries et rapports de cas, incluent l'excision chirurgicale, l'électrodessication et curetage, l'exfoliation chimique, la cryochirurgie et le traitement au laser. Toutefois, comme ces tumeurs sont profondément ancrées dans le derme, tous les traitements sont associés à un risque substantiel de récurrence et peuvent entraîner des cicatrices et des changements pigmentaires. Nous rapportons l'observation d'une patiente de 40 ans sans antécédents qui présentait des papules couleur chair péri-orbitaires dont l'étude histologique était en faveur de syringomes.