Luis Miguel Gutiérrez-Robledo

Luis Miguel Gutiérrez-Robledo
Instituto Nacional De Geriatría · WHO Collaborating Centre on Integrated Care and Public Policy Lab

MD PhD
As a geriatric physician, I help my patients achieve and preserve healthy aging for as long as possible.

About

260
Publications
86,623
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
11,679
Citations
Citations since 2017
107 Research Items
8539 Citations
201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
201720182019202020212022202305001,0001,500
Introduction
As a geriatric physician, I help my patients achieve and preserve healthy aging for as long as possible and help them adapt when their functional health deteriorates. As a scientist I contribute to unraveling the determinants of the aging process to improve healthy life expectancy. As a public health specialist I advise individuals and public and private entities to better adapt to the longevity revolution.
Additional affiliations
June 2012 - May 2020
Instituto Nacional de Geriatria
Position
  • Managing Director
Description
  • Founding Director General
February 2009 - present
Instituto Nacional De Geriatría
Position
  • Director General and researcher
Description
  • Newest Institute at the National Institutes of Health in Mexico
February 2009 - May 2012
Secretaría de Salud
Position
  • Director General
Education
September 2001 - October 2005
Bordeaux School of Public Health
Field of study
  • Public health and aging
November 1996 - September 1997
Paris Diderot University
Field of study
  • biology of aging
September 1985 - November 1987
University of Grenoble
Field of study
  • geriatrics

Publications

Publications (260)
Article
Full-text available
Aging is believed to occur across multiple domains, one of which is body composition; however, attempts to integrate it into biological age (BA) have been limited. Here, we consider the sex-dependent role of anthropometry for the prediction of 10-year all-cause mortality using data from 18,794 NHANES participants to generate and validate a new BA m...
Article
Full-text available
Background In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent of non-COVID deaths on excess mortality, its regional distribution and the association between socio-demographic inequalities have not been characterized. Methods We conducted a retrospective municipal and individual-level study using...
Article
Full-text available
Identifying relationships between components of an index helps to gain a better understanding of the condition they define. The Frailty Index (FI) measures the global health of individuals and can be used to predict outcomes as mortality. Previously, we modelled the relationship between the FI components (deficits) and death through an undirected g...
Article
Full-text available
Objective Identify the association between low physical performance and quality of life in older adults. Methods Cross-sectional analysis of the FraDySMex cohort study (Frailty, Daphnia and Sarcopenia in Mexican Adults). The physical performance was evaluated by Short Physical Performance Battery (SPPB), and the quality of life through the Visual A...
Article
Full-text available
The development of synthetic indexes to measure how societies undertake population aging has become relevant during the last decade due to international interest in responding to demographical changes and in elevating older adults’ standards of living. The measurements proposed are the Global Age Watch Index (GAI), the Active Aging Index (AAI), and...
Poster
Full-text available
A two-arm mixed-method RTC pilot study was conducted in Mexico City to improve residential dementia care (PROCUIDA-Dementia). To assess the power of our study design, a sensitivity analysis was conducted that showed the importance of site and person variability. Here we present an example of sample size simulation for a large-scale replication of t...
Article
Barker's hypothesis affirms that undernourishment in early-life induces metabolic reprogramming that compromises organism functions later in life, leading to age-related diseases. We are exposed to environmental and social conditions that impact our life trajectories, leading to ageing phenotypes as we grow. Epigenetic mechanisms constitute the lin...
Article
Full-text available
Background: Research suggests a significant association between increasing age and memory impairments. Nevertheless, for some individuals, memory performance stays within or above the normative values of younger subjects. This is known as successful memory aging and is associated with specific neurophysiological features and psychological and life...
Preprint
Full-text available
BACKGROUND In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent to which non-COVID deaths contributed to excess mortality, its regional characterization, and the association between municipal-and individual-level sociodemographic inequality has not been characterized. METHODS We conducted a retrosp...
Article
Latin American countries (LAC), with their culturally and ethnically diverse populations, form a region that is difficult to define and to understand. The region's health systems are deeply fragmented, which poses great challenges to overall equity levels in health. This is also one of the fastest ageing regions in the world, with increasing demand...
Preprint
Full-text available
BACKGROUND Vaccination has been effective in ameliorating the impact of COVID-19. However, estimation of vaccine effectiveness (VE) is still unavailable for some widely used vaccines and underrepresented groups. Here, we report on the effectiveness of a nation-wide COVID-19 vaccination program in Mexico. METHODS We used a test-negative design with...
Preprint
Full-text available
Identifying relationships between components of an index helps to have a better understanding of the condition they define. The Frailty Index (FI) measures the global health of individuals and can be used to predict outcomes as mortality. Previously, we modelled the relationship between the FI components (deficits) and death through an undirected g...
Article
Full-text available
Introduction Midlife physical capability (PC) is associated with developmental factors in the populations of economically developed countries. As far as we know, there is no information for rural populations of low- and middle-income countries. The aim of the study was to investigate the influence of pre- and postnatal factors on midlife objective...
Chapter
The study of ageing in developing countries is a relatively new endeavour, which has expanded. Comparative research involving low‐ and middle‐income countries has improved our understanding of the influences of culture and ethnicity, the effects of ageing in low‐income environments, the changing roles of families, and the consequences of new polici...
Article
This study estimates the monetary cost of caregiving - assumed by society and government - for functionally dependent older adults in Mexico. It is a secondary database analysis based on the Mexican Health and Ageing Study 2015 and the National Survey of Household Income and Expenditure 2016. The component costs included were: loss of labor income...
Article
Full-text available
Objective: To identify and quantify potentially inappropriate prescribing (prescripción potencialmente inapropiada, PPI) and other drug prescribing problems in public health care services in a population-based study at the three existing levels of complexity in Mexico. Methods: Descriptive analysis of the Study on Satisfaction of Users of the So...
Article
Objectives To evaluate the feasibility outcomes of implementing a multicomponent staff training intervention (PROCUIDA-Demencia) to promote psychosocial interventions and reduce antipsychotic prescription in Mexican care homes and study its effect on staff's care experience and residents' quality of life. Design A mixed-methods 2-arm cluster rando...
Article
Introduction: Competency-based education has been considered a pedagogical proposal in medicine in recent decades. In clinical contexts, Entrustable Professional Activities (EPA) have been used for the application of competencies. The development of this strategy has been implemented in various specialties to improve the quality of postgraduate med...
Preprint
Full-text available
Aging is believed to occur across multiple domains, one of which is body composition; however, attempts to integrate it into biological age (BA) have been limited. Here, we consider the sex-dependent role of anthropometry for prediction of 10-year all-cause mortality using data from 18,794 NHANES participants to generate and validate a new BA metri...
Article
Full-text available
Abstract: Adverse conditions in early life, including environmental, biological and social influences, are risk factors for ill-health during aging and the onset of age-related disorders. In this context, the recent field of social epigenetics offers a valuable method for establishing the relationships among them However, current clinical studies o...
Article
Full-text available
Objective. To describe the levels of intrinsic capacity and those factors related to its decline in Mexican older adults, using the Mexican Health and Aging Study. Methods. This is a cross-sectional secondary analysis of the 2015 data of the Mexican Health and Aging Study, including adults aged 50 years and above. Selected questions were included t...
Article
Full-text available
Desde 1948, la Organización Mundial de la Salud ha venido publicando un sistema codificado de causas de enfermedad y muerte bajo el nombre genérico de Clasificación Estadística Internacional de Enfermedades (CIE), con revisiones en profundidad cada 10-15 años. En su última versión, CIE-11, se utiliza una terminología para caracterizar la vejez como...
Chapter
By 2025, at least one-fifth of the population of 15 countries in the Americas will be 60 or older (Pan American Health Organization, 2017). The populations of older adults in Mexico and older Latinos in the United States continue to grow dramatically (Central Intelligence Agency, 2015). Population aging is the most important, inevitable feature of...
Chapter
There is a surge of public awareness globally about brain disease, often expressed as apprehension, fear, and requests for more information. Much of this heightened concern is based on knowing someone, or some family member, experiencing a brain disease. As a guiding principle, we could agree that every person has a unique brain capacity that shoul...
Article
Full-text available
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e.,...
Article
Full-text available
Background To determine the association between oral health condition and development of frailty over a 12-month period in community-dwelling older adults. Methods Population-based, case-cohort study derived from the Cohort of Obesity, Sarcopenia, and Frailty of Older Mexican Adults (COSFOMA) study, including data from years 2015 and 2016. Using l...
Article
In this article, we report on the recommendations of a bi-national conference that examined the institutional capacities and future ability of Mexico and the United States to address the need for affordable and sustainable dementia care that results from growing older adult populations. These recommendations reflect the large difference in resource...
Article
Full-text available
The frailty syndrome is a common clinical marker of vulnerability in older adults conducive to an overall decline in inflamma-tory stress responsiveness; yet little is known about the genetic risk factors for frailty in elderly. Our aim was to investigate theassociation between the rs2476601 polymorphism in PTPN22 gene and susceptibility to frailty...
Article
Full-text available
BACKGROUND: The impact of the COVID-19 pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here, we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. METHODS: We analyzed suspected SARS-CoV-2 cases, from the Mexico...
Article
Full-text available
Objective: To calculate the cost assumed by society for having underaged individuals who do not study and provide care to dependent older adults. Materials and methods: The Mexican Health and Ageing Study (MHAS) 2015 was used to calculate the number of underage caregivers who do not attend school. The Household Income and Expenditure Survey (ENI...
Article
Full-text available
Background Whether the metabolically healthy obese (MHO) phenotype is a single, stable or a transitional, fluctuating state is currently unknown. The Mexican-Mestizo population has a genetic predisposition for the development of type 2 diabetes (T2D) and other cardiometabolic complications. Little is known about the natural history of metabolic hea...
Article
Full-text available
Background: Falls are a significant public health problem among older people worldwide. The aim was to perform a new systematic review and meta-analysis to assess whether cataract surgery is effective in reducing the rate of falls in older persons. Methods: The systematic review was performed following the recommendations by the Cochrane Collabo...
Article
Full-text available
BACKGROUND: Chronological age (CA) is a predictor of adverse COVID-19 outcomes; however, CA alone does not capture individual responses to SARS-CoV-2 infection. Here, we evaluated the influence of aging metrics PhenoAge and PhenoAgeAccel to predict adverse COVID-19 outcomes. Furthermore, we sought to model adaptive metabolic and inflammatory respon...
Preprint
Full-text available
The impact of the COVID-19 pandemic in Mexico City has been sharp, as several social inequalities coexist with chronic comorbidities. Here, we conducted an in-depth evaluation of the impact of social, municipal, and individual factors on the COVID-19 pandemic in working-age population living in Mexico City. To this end, we used data from the Nation...
Article
Full-text available
Since the emergence of the COVID-19 pandemic, the most affected population group has been that of older people living in long-term care facilities (LTCFs), which has accumulated between 30 and 60 % of total number of deaths in the world. In Mexico, outbreaks have been reported in LTCFs of at least eight states. Various factors make this population...
Article
Full-text available
The frailty syndrome is a common clinical marker of vulnerability in older adults conducive to an overall decline in inflammatory stress responsiveness; yet little is known about the genetic risk factors for frailty in elderly. Our aim was to investigate the association between the rs2476601 polymorphism in PTPN22 gene and susceptibility to frailty...
Article
Objectives The aim of this study was to compare a short and a long version of an intrinsic capacity index and test their cross-sectional association with relevant health outcomes in older adults.DesignCross-sectional analysis of the baseline data of the FraDySMex study.Participants543 community-dwelling adults aged 50 years and older living in 2 mu...
Article
Full-text available
This study examines sources of vulnerabilities to dementia in low resource populations in two specific contexts—Mexico and the United States. Data are drawn from comparable waves of the Mexican Health and Aging Study (MHAS) and the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) in 2012, which include represent...
Article
Full-text available
Introduction: Substantial gaps in research remain across oldest-old ethnic populations while the burden of dementia increases exponentially with age among Mexican and Mexican American older adults. Methods: Prevalence and correlates of dementia among individuals ≥82 years of age were examined using two population-based cohort studies: The Mexica...
Preprint
Full-text available
INTRODUCTION: Chronological age (CA) is a predictor of adverse COVID-19 outcomes; however, CA alone does not capture individual responses to SARS-CoV-2 infection. Here, we evaluated the influence of aging metrics PhenoAge and PhenoAgeAccel to predict adverse COVID-19 outcomes. Furthermore, we sought to model adaptive metabolic and inflammatory resp...
Article
Full-text available
Background Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. Aim To identify and define the characteristic...
Article
Background and Aims Both insulin resistance (IR) and visceral adipose tissue (VAT) are related cardiometabolic risk factors, nevertheless its joint effect on endothelial functionality are controversial. To evaluate the joint effect of IR and VAT on endothelial functionality using the pulse-waveform analysis; explore the mediating role of VAT on the...
Article
The aging process has been linked to the occurrence of chronic diseases and functional impairments, including cancer, sarcopenia, frailty, metabolic, cardiovascular, and neurodegenerative diseases. Nonetheless, aging is highly variable and heterogeneous and represents a challenge for its characterization. In this sense, intrinsic capacity (IC) stan...
Article
Full-text available
Background: Due to a high prevalence of chronic non-degenerative diseases, it is suspected that COVID 19 poses a high risk of fatal complications for the Mexican population. The present study aims to estimate the risk factors for hospitalization and death in the Mexican population infected by SARS-CoV-2. Methods and findings: We used the publicl...
Article
Objectives Intrinsic capacity is a composite of five domains that summarizes the physical and mental capacities of an individual. Intrinsic capacity is increasing in relevance for adapting health systems to population ageing. Therefore, our objective was to analyse how intrinsic capacity has been assessed in older adults and if these measurements h...
Article
Background Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. Aim To identify and define the characteristics...
Article
Objectives: To identify trajectories of depression and daily disability in the context of serious falls and widowhood and to predict those trajectories before the events occurred. Methods: Longitudinal data were used from the Mexican Health and Aging Study. Trajectories were estimated using latent class growth analysis. Internal and socio-ecologica...
Article
Full-text available
BACKGROUND COVID-19 has had a disproportionate impact on older adults. Mexico's population is younger, yet COVID-19’s impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological ag...
Article
Objectives Intrinsic capacity is a composite of five domains that summarizes the physical and mental capacities of an individual. Intrinsic capacity is increasing in relevance for adapting health systems to population ageing. Therefore, our objective was to analyse how intrinsic capacity has been assessed in older adults and if these measurements h...
Preprint
Full-text available
BACKGROUND: COVID-19 has had a disproportionate impact on older adults. The population of Mexico is younger, yet the impact of COVID-19 on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chron...
Preprint
Full-text available
Background. With its high prevalence of chronic non-degenerative diseases, it is suspected that in Mexico there is a high risk of fatal complications from COVID-19. The present study aims to estimate the risk factors for hospitalisation and death in the Mexican population infected by SARS-CoV-2. Methods and Findings. We used the publicly available...
Article
Full-text available
Objectives: Use latent class analysis (LCA) to identify patterns of multidimensional dependency in a sample of older adults and assess sociodemographic, predictors of class membership. Material and methods: Longitudinal data were used from the Mexican Health and Aging Study (MHAS). 7,920 older adults, 55% women, were recruited. LCA were used to ide...
Article
Full-text available
The demographic transition, population aging, and the epidemiological transition in Mexico have modified the burden of the disease profile, and impose important economic, social, and health care challenges, particularly old-age and disability-related care dependency. We describe old age health and dependency conditions, and analyze the supply of se...
Article
Full-text available
Background: The number of older adults expected to increase over the coming decades, the public health impact in this population may be substantial, and a greater understanding of the structure underlying risk factor presentation as a potential source of heterogeneity is critical. Objective: Identify and characterize profiles of dependency status i...
Article
Full-text available
Frailty remains a challenge in the aging research area with a number of gaps in knowledge still to be filled. New approaches to its study have been proposed, including the one discussed in this article. We tested frailty as through the use of graphical probabilistic models (bayesian networks) with empirical data. Data from the Mexican Health and Ag...
Article
Background: Frailty remains a challenge in the aging research area with a number of gaps in knowledge still to be filled. Frailty seems to behave as a network, and in silico evidence is available on this matter. Having in vivo evidence that frailty behaves as a complex network was the main purpose of our study. Methods: Data from the Mexican Hea...
Article
Full-text available
• Numerous underlying physiological changes occur with increasing age, and for older people, the risks of developing chronic diseases and care dependency increase. • Health systems are often better designed to respond to episodic health needs than to the more complex and chronic health needs that tend to arise with increasing age, and reprioritizat...
Article
Full-text available
Objective The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. Methods These recommendations were formed using the GRADE approach, w...
Article
Objectives Intrinsic capacity (IC) is one of the latest views of positive aging. In its current status lacks a biological substrate amenable to be intervened. The aim of this study was to determine the association of allostatic load (AL) with IC. Design We present a cross-sectional analysis of the Costa Rican Longevity and Healthy Aging Study. Se...
Chapter
In developed countries, trends in adjusted end-stage renal disease incidence rate are displaying a rising trend, particularly in the older age group. These trends pose major challenges to healthcare systems, given the greater healthcare utilization by and more comorbid conditions among elderly adults. Older patients with kidney disease face both a...
Article
Full-text available
Frailty is an age-associated condition, characterized by an inappropriate response to stress that results in a higher frequency of adverse outcomes (e.g., mortality, institutionalization and disability). Some light has been shed over its genetic background, but this is still a matter of debate. In the present study, we used network biology to analy...
Article
Full-text available
Hypertension is associated with insulin resistance (IR), metabolic syndrome (MS) and arterial stiffness. Non-insulin-based IR indexes were developed as tools for metabolic screening. Here, we aimed to evaluate the novel non-insulin-based METS-IR index for prediction of incident hypertension and arterial stiffness evaluated using pulse-wave velocity...
Article
Objectives: To assess the burden of disease and disability in older persons in Mexico from the Global Burden of Disease (GBD) 2016 study data. Methods: Analysis of the Mexican data from the GBD 2016 study is presented by state, sex, and stratified into four age groups: 60 to 69, 70 to 79, 80 to 89, and 90+ years. Results: The majority of disab...
Article
Full-text available
Mexico's National Institute of Geriatrics (INGER) is the national research center of reference for matters related to human aging. INGER scientists perform basic, clinical, and demographic research which may imply different scientific cultures working together in the same specialized institution. In this paper, by a combination of text mining, coau...
Data
Collaboration network model of INGER authors sliced by years (2012–2017) is shown. The authors were equally colored as in Figure 2.
Article
Full-text available
Background: Mortality in Mexico has decreased substantially in the last years; however, there are segments of the population that experience social deprivation. Objective: To identify and describe at the national level the causes of death by degree of social deprivation (DSD), age and sex. Methods: We analyzed variables from the Censo de Vivie...
Book
This book presents new insights into the consequences of the impending growth in and impact of the older segment of aging communities on local economies. It uses a comparative research framework to further our understanding of issues in health and aging in the transnational context of the health and migratory experience of the U.S.- Mexican populat...
Chapter
Full-text available
Se analizan los hechos más destacados que ilustran la situación actual de salud de las personas mayores en México, con base en evidencias recogidas a lo largo de los últimos años. La información contenida permite mostrar un panorama amplio de las distintas dimensiones de la salud de este grupo poblacional. A partir de estos datos se delinean las es...
Article
Objectives Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Re...
Article
Full-text available
Non-contributory pension programs in the developing world seek to provide older adults with an income that may improve their health and wellbeing in old age by enabling access to health care and better nutrition. There is no previous evidence of the effects of non-contributory pensions on frailty, a comprehensive measure of health and well-being of...