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BACKGROUND: Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance. METHODS: A systematic review was performed including studies whose participants' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve. RESULTS: a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time. CONCLUSIONS: Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.
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Força da Mão , Dinamômetro de Força Muscular , Humanos , Força da Mão/fisiologia , Feminino , Masculino , Fadiga Muscular/fisiologia , Idoso , Músculo Esquelético/fisiologia , Força Muscular , Pessoa de Meia-Idade , Sarcopenia/diagnóstico , Sarcopenia/fisiopatologia , Fatores de Tempo , AdultoRESUMO
BACKGROUND: Frailty and sarcopenia have been extensively studied in heart failure (HF) patients, but their coexistence is unknown. The aim of this work is to describe the coexistence of these conditions in a sample of HF outpatients and its association with the use of medication and left-ventricular ejection fraction. METHODS: Participants in this cross-sectional study were recruited from a HF outpatients' clinic in northern Portugal. Frailty phenotype was assessed according to Fried et al. Sarcopenia was evaluated according to the revised consensus of the European Working Group on Sarcopenia in Older People. RESULTS: A total of 136 HF outpatients (33.8% women, median age 59 years) integrated this study. Frailty and sarcopenia accounted for 15.4% and 18.4% of the sample, respectively. Coexistence of frailty and sarcopenia was found in 8.1% of the participants, while 17.6% had only one of the conditions. In multivariable analysis (n = 132), increasing age (OR = 1.13;95%CI = 1.06,1.20), being a woman (OR = 65.65;95%CI = 13.50, 319.15), having heart failure with preserved ejection fraction (HFpEF) (OR = 5.61; 95%CI = 1.22, 25.76), and using antidepressants (OR = 11.05; 95%CI = 2.50, 48.82), anticoagulants (OR = 6.11; 95%CI = 1.69, 22.07), furosemide (OR = 3.95; 95%CI = 1.07, 14.55), and acetylsalicylic acid (OR = 5.01; 95%CI = 1.10, 22.90) were associated with increased likelihood of having coexistence of frailty and sarcopenia, while using statins showed the inverse effect (OR = 0.06; 95%CI = 0.01, 0.30). CONCLUSIONS: The relatively low frequency of coexistence of frailty and sarcopenia signifies that each of these two conditions still deserve individual attention from health professionals in their clinical practice and should be screened separately. Being a woman, older age, having HFpEF, using anticoagulants, antidepressants, loop diuretics and acetylsalicylic acid, and not using statins, were associated with having concomitant frailty and sarcopenia. These patients can potentially benefit from interventions that impact their quality of life such as nutritional and mental health interventions and exercise training.
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Fragilidade , Insuficiência Cardíaca , Inibidores de Hidroximetilglutaril-CoA Redutases , Sarcopenia , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Masculino , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia , Sarcopenia/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Volume Sistólico , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Estudos Transversais , Função Ventricular Esquerda , Qualidade de Vida , Pacientes Ambulatoriais , Anticoagulantes , Antidepressivos , AspirinaRESUMO
BACKGROUND: Sarcopenia is prevalent in heart failure (HF) patients, contributing to its poor prognosis. Statin use is postulated as a probable risk for developing sarcopenia, but little is known regarding this association in HF patients. This work aims at classifying and characterising sarcopenia and at describing the association of statin use with sarcopenia in a sample of Portuguese HF outpatients. METHODS: In this cross-sectional study, a sample of 136 HF patients (median age: 59 years, 33.8% women) was recruited from an HF outpatients' clinic of a University Hospital in Portugal. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2. Clinical, nutritional, and dietary data were collected. RESULTS: A total of 25 (18.4%) individuals were categorised as sarcopenic, ranging from 12.2% in younger (< 65 years) participants vs. 30.4% in older ones and from 3.3% in men vs. 47.8% in women. Severe sarcopenia accounted for 7.4% of the sample and sarcopenic obesity was identified in 5.1% of the individuals. A total of 65.4% of the participants were statin users. In multivariable analysis (n = 132, 25 sarcopenic), the use of statins was inversely associated with sarcopenia (OR = 0.03; 95% CI = 0.01, 0.30). Each additional age year was associated with a 9% increase in the likelihood of being sarcopenic (OR = 1.09; 95% CI = 1.01, 1.17), and each Kg.m-2 increment in body mass index was associated with a 21% decrease in the likelihood of sarcopenia (OR = 0.79; 95% CI = 0.65, 0.96). The daily use of five or more medicines was also directly associated with sarcopenia (OR = 26.87; 95% CI = 2.01, 359.26). On the other hand, being a man and being physically active were inversely associated with sarcopenia (OR = 0.01; 95% CI = 0.00, 0.07 and OR = 0.09; 95% CI = 0.01, 0.65, respectively). CONCLUSIONS: Contrary to what was expected, patients medicated with statins were less likely to be sarcopenic. Although this finding deserves further research, we hypothesise that this might be related to the pleiotropic effects of statins on endothelial function, contributing to better neuromuscular fitness.
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Insuficiência Cardíaca , Inibidores de Hidroximetilglutaril-CoA Redutases , Sarcopenia , Idoso , Estudos Transversais , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Sarcopenia/complicações , Sarcopenia/diagnóstico , Sarcopenia/epidemiologiaRESUMO
Population aging is a reality resulting in polymedication and its harmful consequences. Therefore, determining polymedication state in Portugal and identifying its associated characteristics is vital. Methods: Among the cross-sectional study Nutrition UP 65, information on socio-demographic data, cognitive performance, lifestyle, health, and nutritional status was collected in the Portuguese older population. Frequency of polymedication (self-reported concomitant administration of ≥5 medications and/or supplements) was calculated. Associated factors were determined. Results: A total of 1317 individuals were included in the sample and the frequency of polymedication was 37.1%. Characteristics associated with higher odds of polymedication were living in an institution (OR: 1.97; CI: 1.04-3.73); being overweight (OR: 1.52; CI: 1.03-2.25) or obese (OR: 1.57; CI: 1.06-2.34); perceiving health status as reasonable (OR: 1.68; CI: 1.25-2.27) or bad/very bad (OR: 2.04; CI: 1.37-3.03); having illnesses of the circulatory system (OR: 2.91; CI: 2.14-3.94) or endocrine, metabolic, and nutritional diseases (OR: 1.79; CI: 1.38-2.31). Conclusions: A 3 to 4 out of 10 Portuguese older adults are polymedicated. Intervention in modifiable factors and the monitorization of others is an important strategy in the care of the elderly.
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AIM: To investigate the association between nutritional and functional status of Alzheimer's disease patients and caregivers' burden. METHODS: A cross-sectional study was conducted among 79 community-dwelling Alzheimer's disease patients living with their caregivers. Caregivers' burden was assessed using the Zarit Burden-Interview. Multinomial logistic regressions were carried out using caregivers' burden as the dependent variable. RESULTS: Caregivers' severe overload was strongly associated with weight loss of more than 3 kg during the previous 3 months (OR = 7.34; 95% CI: 2.02-26.65), lower values of calf girth (OR = 3.20; 95% CI: 1.03-9.93), sarcopenia status (OR = 3.50; 95% CI: 1.09-11.22), and lower gait speed values (OR = 3.83; 95% CI: 1.18-12.47). Otherwise, overweight or obesity (OR = 0.21; 95% CI: 0.05-0.83), was related to lower odds of higher caregivers' burden. CONCLUSION: In community-dwelling older adults with Alzheimer's disease, the nutritional and functional status impairments were strongly associated with increasing caregivers' burden, whereas overweight conferred protection.
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Doença de Alzheimer , Cuidadores , Idoso , Efeitos Psicossociais da Doença , Estudos Transversais , Estado Funcional , Humanos , Sobrepeso , Escalas de Graduação PsiquiátricaRESUMO
Aim: Sarcopenia and malnutrition are highly prevalent in older adults undergoing hemodialysis (HD) and are associated with negative outcomes. This study aimed to evaluate the role of sarcopenia and malnutrition combined on the nutritional markers, quality of life, and survival in a cohort of older adults on chronic HD. Methods: This was an observational, longitudinal, and multicenter study including 170 patients on HD aged >60 years. Nutritional status was assessed by 7-point-subjective global assessment (7p-SGA), body composition (anthropometry and bioelectrical impedance), and appendicular skeletal muscle mass (Baumgartner's prediction equation). Quality of life was assessed by KDQoL-SF. The cutoffs for low muscle mass and low muscle strength established by the 2019 European Working group on sarcopenia for Older People (EWGSOP) were used for the diagnosis of sarcopenia. Individuals with a 7p-SGA score ≤5 were considered malnourished, individuals with low strength or low muscle mass were pre-sarcopenic, and those with low muscle mass and low muscle strength combined as sarcopenic. The sample was divided into four groups: sarcopenia and malnutrition; sarcopenia and no-malnutrition; no-sarcopenia with malnutrition; and no-sarcopenia and no-malnutrition. Follow-up for survival lasted 23.5 (12.2; 34.4) months. Results: Pre-sarcopenia, sarcopenia, and malnutrition were present in 35.3, 14.1, and 58.8% of the patients, respectively. The frequency of malnutrition in the group of patients with sarcopenia was not significantly higher than in the patients without sarcopenia (66.7 vs. 51.2%; p = 0.12). When comparing groups according to the occurrence of sarcopenia and malnutrition, the sarcopenia and malnutrition group were older and presented significantly lower BMI, calf circumference, body fat, phase angle, body cell mass, and mid-arm muscle circumference. In the survival analysis, the group with sarcopenia and malnutrition showed a higher hazard ratio 2.99 (95% CI: 1.23: 7.25) for mortality when compared to a group with no-sarcopenia and no-malnutrition. Conclusion: Older adults on HD with sarcopenia and malnutrition combined showed worse nutritional parameters, quality of life, and higher mortality risk. In addition, malnutrition can be present even in patients without sarcopenia. These findings highlight the importance of complete nutritional assessment in patients on dialysis.
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BACKGROUND: Dual x-ray absorptiometry (DXA) is widely adopted to estimate muscle mass for research, but for daily practice is only available in a limited number of facilities. AIM: To elucidate if it is anthropometry or bioelectrical impedance analysis (BIA) the method more concordant with DXA in estimating muscle mass for sarcopenia diagnosis among older adults, and to investigate the impact of several cut-off points in sarcopenia frequency. METHODS: 159 older adults (≥65 years) were included in a cross-sectional analysis. Sarcopenia was identified using the 2018 EWGSOP2 definition, plus previous definitions for muscle mass. Estimation of muscle mass by DXA (appendicular skeletal muscle mass (ASM) and ASM/height2), by BIA (skeletal muscle mass/height2 (SMM/height2) and skeletal muscle mass index (SMI)), and anthropometry (calf and mid-arm muscle circumferences (CC and MAMC, respectively)) was carried out, as well as measurements of handgrip strength and gait speed. RESULTS: Sarcopenia frequency varied from 5.0 to 42.1% depending on the method and cut-off point applied. All surrogate diagnostic criteria had a higher agreement with the DXA defined criterion ASM over ASM/height2. A substantial agreement was also found with BIA SMM/height2 (κ= 0.67), and with BIA SMI (κ= 0.65), and a moderate agreement with MAMC (κ= 0.42), p<0.001. Using the DXA ASM and ASM/height2 criteria as reference, CC showed a specificity of 100% and 94%, respectively. CONCLUSIONS: BIA is a suitable method to evaluate muscle mass in sarcopenia diagnosis when DXA is unavailable. Furthermore, CC showed to be a valid indicator to rule in the presence of sarcopenia.
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Sarcopenia , Absorciometria de Fóton , Idoso , Composição Corporal , Estudos Transversais , Impedância Elétrica , Força da Mão , Humanos , Músculo Esquelético/diagnóstico por imagem , Sarcopenia/diagnóstico por imagemRESUMO
BACKGROUND: Assessing body weight in older adults may be challenging. Hence, the present study aimed to develop and cross-validate updated and reproducible equations to estimate body weight in a large sample of older adults, namely among the older-old. METHODS: In total, 1456 individuals aged ≥ 65 years, from the Nutrition UP 65 study, were included in the present analysis. The participants were randomly assigned to one of two sub-samples: development (n = 991) and validation samples (n = 465). Prediction equations using height, mid-upper arm circumference (MUAC), waist circumference (WC), calf circumference (CC) and triceps skinfold thickness (TST) were generated for the development sample using multiple regression analysis and then validated using the validation sample. RESULTS: The model with five predictor variables generated the following equations: females 65-79 years: -114.682 + 0.522 × height (cm) + 0.620 × MUAC (cm) + 0.517 × WC (cm) + 0.893 × CC (cm) + 0.111 × TST (mm) (adjusted r2 = 0.883, standard error of the estimate (SEE) = 4.4); females ≥ 80 years: -110.806 + 0.494 × height (cm) + 0.637 × MUAC (cm) + 0.500 × WC (cm) + 0.986 × CC (cm) + 0.021 × TST (mm) (adjusted r2 = 0.890, SEE = 3.9); males 65-79 years: -114.875 + 0.558 × height (cm) + 0.073 × MUAC (cm) + 0.671 × WC (cm) + 0.717 × CC (cm) + 0.182 × TST(mm) (adjusted r2 = 0.820, SEE=5.0); and males ≥ 80 years: -128.789 + 0.546 × height (cm) + 0.202 × MUAC (cm) + 0.612 × WC (cm) + 1.236 × CC (cm) + 0.093 × TST (mm) (adjusted r2 = 0.906, SEE = 3.5). CONCLUSIONS: Body weight can be estimated with good accuracy in older adults using these sex- and age-specific equations generated from regression models using three to five anthropometric predictor variables.
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Estatura , Estado Nutricional , Idoso , Antropometria , Braço/anatomia & histologia , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Masculino , Circunferência da CinturaRESUMO
BACKGROUND: Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross-sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults. METHODS: A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24-h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day-1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS: Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06-7.15). CONCLUSIONS: These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.
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Ingestão de Líquidos , Sódio na Dieta , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Estado Nutricional , Razão de Chances , Cloreto de Sódio na Dieta , Sódio na Dieta/efeitos adversosRESUMO
The association between frailty and obesity may differ according to the heterogeneity of body mass index (BMI) and waist circumference (WC) phenotypes in older adults. We hypothesized that the use of simple indicators of general and abdominal obesity combined, may more accurately represent obesity and allow to further elucidate on how frailty status and its criteria are related to obesity. A sample of 1444 older adults, aged ≥65 years (Nutrition UP 65 study) was included in a cross-sectional analysis. General and abdominal obesity were defined according to World Health Organization BMI and WC cut-offs, and frailty by Fried et al. phenotype. A cluster analysis defined groups according to BMI and WC levels. Overweight (BMI between 25.0 and 29.9 kg/m2; 44.6%), general obesity (BMI ≥30.0 kg/m2; 39.0%), and abdominal obesity (WC >102 cm for men and >88 cm for women) were highly frequent (66.5%). Prefrailty (odds ratio [OR]: 2.33; 95% confidence interval [CI]: 1.52-3.57) and frailty (OR: 2.87; 95% CI: 1.58-5.22) were directly associated with the "general and abdominal obesity" cluster. Regarding frailty criteria, low handgrip strength (OR: 2.29; 95% CI: 1.55-3.38) and weight loss (OR: 0.27; 95% CI: 0.14-0.52) were also associated with this cluster. In this sample of older adults presenting a high frequency of overweight and obesity, prefrailty and frailty are linked to higher levels of adiposity, but only when both general and abdominal obesity are present. Present results emphasize the importance of the evaluation of both BMI and WC in the geriatric clinical practice and suggest that older adults presenting both general and abdominal obesity should be routinely screened for frailty.
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Fragilidade/complicações , Obesidade Abdominal/complicações , Obesidade/complicações , Gordura Abdominal , Adiposidade , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Idoso Fragilizado , Força da Mão , Humanos , Masculino , Sobrepeso/complicaçõesRESUMO
Despite the well-known benefits of the Mediterranean Diet (MedDiet), data on the sodium intake is scarce. This study aimed to quantify the association between sodium excretion and the adherence to the MedDiet in the elderly. A representative sample of 1500 Portuguese adults (≥65 years) was assessed (1321 were eligible for the present analysis). A 24 h urine sample was collected and analysed for creatinine and sodium. Excessive sodium intake was defined as above 2000 mg/day. The adherence to the MedDiet was assessed by the PREDIMED. A binary logistic regression model was conducted to evaluate the association between urinary sodium excretion and the adherence to the MedDiet. Odds Ratios (OR) and respective 95% Confidence Intervals (95% CI) were calculated. Excessive sodium excretion was observed in 80.0% of men and 91.5% of women whereas a high adherence to the MedDiet was reported by 42.2% of women and 46.4% of men. After adjusting for confounders, excessive sodium excretion was associated with a high adherence to the MedDiet in men (OR = 1.94; 95% CI: 1.03-3.65) but not in women. These results show that the MedDiet can be an important source of sodium and highlight the need for implementing strategies to reduce sodium intake when following a MedDiet.
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Dieta Mediterrânea , Sódio/urina , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Avaliação Nutricional , Razão de Chances , Portugal , Fatores de RiscoRESUMO
BACKGROUND: Undernutrition is associated with increased hospital length of stay (LOS). Anthropometrics is required for undernutrition screening and diagnosis. However, the measurements which are more strongly associated with LOS are to be specified. This study aims to measure the independent association of weight, triceps skinfold thickness (TST), mid-upper arm circumference (MUAC), adductor pollicis muscle thickness (APMT), mid-upper arm muscle area (AMA), mid-upper arm muscle circumference (AMC), and body mass index (BMI) with LOS and investigating whether these indicators had similar validity in predicting LOS. METHODS: Six hundred ninety-five patients participated in a prospective observational study. Participants were dichotomized indicators studied according to the 5th and 25th percentiles described in the literature (for APMT only the 5th percentile was used). Cox regression analysis was used to estimate adjusted hazard ratios (HRs) and corresponding 95% CIs. RESULTS: Patients that presented values <5th percentile for TST (HR, 0.759; 95% CI, 0.579-0.995), MUAC (HR, 0.822; 95% CI, 0.687-0.983), APMT (HR, 0.791; 95% CI, 0.671-0.933), AMA (HR, 0.797, 95% CI, 0.660-0.962), and AMC (HR, 0.746; 95% CI, 0.611-0.911) showed a lower probability of being discharged to usual residence. Patients whose TST values were <25th percentile also presented lower probability of being discharged to usual residence (HR, 0.798; 95% CI, 0.673-0.946). No associations were found between weight and BMI with LOS. CONCLUSION: Depletion of TST, MUAC, APMT, AMA, and AMC was associated with lower probability of being discharged to usual residence. A thicker TST was independently associated with this outcome and thus TST should be considered for undernutrition screening and diagnosis.
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Desnutrição , Estado Nutricional , Antropometria , Braço , Índice de Massa Corporal , Estudos Transversais , Humanos , Tempo de Internação , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Avaliação NutricionalRESUMO
Older adults are particularly susceptible to sedentary behaviours. Sitting time has been increasingly referred to as a potentially modifiable risk factor in the prevention of chronic diseases. Identifying factors associated with sitting time, particularly those that are modifiable, will allow for more effective public health strategies. This study aimed to describe sitting time among Portuguese older adults and to evaluate associated factors. A cross-sectional study including 1423 older adults ≥ 65 years old was conducted. Sitting time was assessed with the International Physical Activity Questionnaire. Socio-demographic, health, anthropometric and functional variables were collected. Bivariate and multivariate linear regression models were conducted to study the association between these variables and sitting time. The median of sitting time was 300 min/day (interquartile range = 240 min/day), which is equal to 5 h/day. The following factors were directly associated with longer sitting time: being male, age ≥ 80 years, living in Central or Southern Portugal, being retired from work, as well as presenting low physical activity, obesity or longer time to walk 4.6 metres. On the other hand, being married, having higher education and higher household income were inversely associated with longer sitting time. It can be concluded that Portuguese older adults spend a considerable amount of time sitting per day. Potentially modifiable risk factors associated with longer sitting time in this population were related to nutritional status and functional ability.
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Objective: Older adults present higher risk of functional disability detected by handgrip strength and an increased risk of poor health conditions, such as dehydration and low values of the sodium-to-potassium (Na/K) ratio. This study aimed to quantify the association of hydration status and Na/K ratio with handgrip strength, based on the urinary excretion of older adults.Methods: A cross-sectional study was conducted in 735 older adults ≥ 65 years old. Handgrip strength was measured with a Jamar Dynamometer and low values were defined according to body mass index and to sex-specific cutoff points. The hydration status was evaluated based on free water reserve. Sodium and potassium intake were evaluated after converting 24-hour urinary sodium and potassium excretion, respectively. A logistic regression model was used to estimate the probability of presenting low handgrip strength, according to risk of hypohydration and to quartiles of Na/K, stratified by sex and adjusted for potential confounders.Results: The adjusted odds ratio (OR) for presenting low handgrip strength was higher in women at risk of hypohydration, but this association was not found in men. Both women and men with the highest values of Na/K ratio presented higher adjusted OR for low handgrip strength (OR in women was 2.03; 95% confidence interval [CI]: 1.12-3.68, and in men was 2.19; 95% CI: 1.11-4.29).Conclusions: The risk of hypohydration was directly associated with low handgrip strength in older women. In older adults, higher values of urinary Na/K ratio were also directly associated with low handgrip strength.
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Força da Mão , Estado de Hidratação do Organismo , Potássio/urina , Sódio/urina , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Desidratação/epidemiologia , Feminino , Humanos , Masculino , Razão de Chances , Fatores SexuaisRESUMO
AIM: The aim of this study was to describe sarcopenia frequency, to identify the factors associated with sarcopenia and undernutrition, and to evaluate their coexistence. METHODS: A total of 1500 Portuguese older adults aged ≥65 years from the Nutrition UP 65 study were evaluated using a cross-sectional analysis. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP)2 guidelines (2018), using anthropometric measures. Undernutrition status was evaluated by Mini-Nutritional Assessment-Short Form. RESULTS: Sarcopenia frequency was 4.4% (n = 66). Sarcopenia coexists with undernutrition or undernutrition risk in 1.5% of this sample. In the multivariate analysis, sarcopenia was directly associated with age >75 years (odds ratio (OR): 2.14; 95% confidence interval (CI): 1.19-3.84), undernutrition or undernutrition risk (OR: 1.86; 95% CI: 1.01-3.43) and inversely associated with male gender (OR: 0.52; 95% CI: 0.29-0.97), overweight (OR: 0.24; 95% CI: 0.13-0.42) or obesity (OR: 0.02; 95% CI: 0.01-0.09) and moderate alcohol consumption (OR: 0.47; 95% CI: 0.24-0.90). Undernutrition or undernutrition risk was associated with a poor or very poor self-perception of health status (OR: 3.53; 95% CI: 2.32-5.37), a low physical activity level (OR: 1.74; 95% CI: 1.23-2.47), sarcopenia (OR: 1.85; 95% CI: 1.02-3.36), and being overweight (OR: 0.40; 95% CI: 0.27-0.59) or obese (OR: 0.43; 95% CI: 0.28-0.65). CONCLUSIONS: The majority of the older adults presented low muscle strength (probable sarcopenia), but only a small number had concomitantly low muscle quantity or quality (sarcopenia). Coexistence between these conditions is low which reinforces the need to assess them both individually during geriatric assessment.
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Desnutrição/complicações , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Força Muscular , Avaliação Nutricional , Portugal/epidemiologia , Sarcopenia/complicaçõesRESUMO
OBJECTIVES: The aim of this study was to evaluate adherence to the Mediterranean dietary pattern (MDP) and its associated factors in older Portuguese adults. METHODS: A cross-sectional observational study was designed. In the context of the Nutrition UP 65 study, a national cluster sample of 1407 Portuguese individuals ≥65 y of age was analyzed. Adherence to the MDP was evaluated with the Portuguese version of the Prevention with Mediterranean Diet tool. The association between an individual's characteristics and adherence to the MDP was analyzed through hierarchical logistic regression analysis. RESULTS: In this study, 43% of participants adhered to the MDP (nâ¯=â¯609). Higher educational level (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.54-3.69), living in the center (OR, 1.35; 95% CI, 1.01-1.79), being married or living in a common-law marriage (OR, 1.54; 95% CI, 1.20-1.97), and body mass index (ORpreobese, 1.52; 95% CI, 1.02-2.25) were related with increased odds of adherence to the MDP. Otherwise, lower adherence to the MDP was found for participants who were ≥80 y of age (OR, 0.70; 95% CI, 0.52-0.94), who lived in Madeira (OR, 0.35; 95% CI, 0.14-0.89) and Azores (OR, 0.28; 95% CI, 0.08-0.99), who rated their health as moderate (OR, 0.65; 95% CI, 0.50-0.84) or as bad or very bad (OR, 0.63; 95% CI, 0.45-0.90), and those who reported six or more comorbidities (OR, 0.62; 95% CI, 0.39-0.97). CONCLUSIONS: Of the sample, 57% did not adhere to the Mediterranean diet. Potentially modifiable factors associated with lower adherence to the MDP were lower educational and health status.
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Dieta Mediterrânea/psicologia , Comportamento Alimentar/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Escolaridade , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , PortugalRESUMO
BACKGROUND: How nutrition status indicators relate to function in older adults is an issue that needs to be explored. This study aimed to quantify the associations of anthropometric parameters and nutrition status indicators with hand grip strength (HGS) and gait speed (GS) in older adults. METHODS: A cross-sectional observational study was conducted in a population-based sample of 1500 older adults ≥65 years old. Logistic regression models were used to explore the associations between anthropometric, nutrition, and functional measures. RESULTS: Lower values of height, mid-arm muscle circumference, and calf circumference, as well as higher values of waist circumference, were associated with both low GS and HGS. The adjusted odds ratio (OR) for low GS was around 2-fold higher in participants presenting risk for undernutrition or undernutrition. The adjusted OR (95% confidence interval) for low HGS was 1.54 (1.01-2.36) in women and 1.57 (0.91-2.72) in men at risk for undernutrition/undernutrition. CONCLUSIONS: In older adults, lower values of height and calf circumference, as well as higher waist circumference, were associated with both low GS and HGS. Lower values of mid-arm muscle circumference were also associated with low values of both functional parameters only in men. The risk for undernutrition/undernutrition was more strongly associated with low GS than with low HGS in both women and men.
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Antropometria/métodos , Avaliação Geriátrica/métodos , Força da Mão/fisiologia , Estado Nutricional/fisiologia , Velocidade de Caminhada/fisiologia , Idoso , Análise por Conglomerados , Estudos Transversais , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Masculino , PortugalRESUMO
OBJECTIVE: To characterise the nutritional status and to identify malnutrition-associated variables of older adults living in Portuguese nursing homes. DESIGN: Cross-sectional study. Data on demographic and socio-economic characteristics, self-reported morbidity, eating-related problems, nutritional status, cognitive function, depression symptoms, loneliness feelings and functional status were collected by trained nutritionists through a computer-assisted face-to-face structured interview followed by standardised anthropometric measurements. Logistic regression was used to identify factors associated with being at risk of malnutrition/malnourished. SETTING: Portuguese nursing homes. SUBJECTS: Nationally representative sample of the Portuguese population aged 65 years or over living in nursing homes. RESULTS: A total of 1186 individuals (mean age 83·4 years; 72·8 % women) accepted to participate. According to the Mini Nutritional Assessment, 4·8 (95 % CI 3·2, 7·3) % were identified as malnourished and 38·7 (95 % CI 33·5, 44·2) % were at risk of malnutrition. These percentages increased with age and were significantly higher for women. Logistic regression showed (OR; 95 % CI) that older adults reporting no or little appetite (6·5; 2·7, 15·3), those revealing symptoms of depression (2·6; 1·6, 4·2) and those who were more dependent in their daily living activities (4·7; 2·0, 11·1) were also at higher odds of being malnourished or at risk of malnutrition. CONCLUSIONS: Malnutrition and risk of malnutrition are prevalent among nursing home residents in Portugal. It is crucial to routinely screen for nutritional disorders, as well as risk factors such as symptoms of depression and lower functional status, to prevent and treat malnutrition.
RESUMO
BACKGROUND: Vitamin D deficiency is common in older adults and has been linked with frailty and obesity, but it remains to be studied whether frail obese older adults are at higher risk of vitamin D deficiency. Therefore, the aim of this study is to explore the association between frailty, obesity indices and serum 25(OH)D concentrations. METHODS: 1447 individuals with 65 years or older, participating in a cross-sectional study (Nutrition UP 65) were included. Frailty, according to Fried et al., body mass index (BMI), waist circumference (WC), body roundness index (BRI) and body shape index (ABSI) were evaluated. A stepwise multinomial logistic regression was carried out to quantify the association between 25(OH)D quartiles and independent variables. RESULTS: Median 25(OH)D levels were lower in individuals presenting both frailty and obesity (p<0.001). In the multivariate analysis, pre-frailty (OR: 2.65; 95% CI: 1.63-4.33) and frailty (OR: 3.77; 95% CI: 2.08-6.83) were associated with increased odds of lower 25(OH)D serum levels (first quartile). Regarding obesity indices, the highest categories of BMI (OR: 1.74; 95% CI: 1.06-2.86), WC (OR: 3.46; 95% CI: 1.95-6.15), BRI (OR: 4.35; 95% CI: 2.60-7.29) and ABSI (OR: 3.17 95% CI: 1.86-5.38) were directly associated with lower 25(OH)D serum levels (first quartile). CONCLUSIONS: A positive association between frailty or obesity and lower vitamin D levels was found. Moreover, besides BMI and WC, other indicators of body adiposity, such as BRI and ABSI, were associated with lower 25(OH)D serum concentrations.
Assuntos
Calcifediol/sangue , Fragilidade/sangue , Fragilidade/epidemiologia , Obesidade/sangue , Obesidade/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adiposidade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Idoso Fragilizado , Humanos , Masculino , Fatores de Risco , Deficiência de Vitamina D/sangueRESUMO
BACKGROUND: Although undernutrition and sarcopenia are common among older adults and both result in worse health outcomes, data concerning the burden of these conditions in Portuguese community-dwelling older adults are scarce. OBJECTIVE: The aim of this study was to firstly describe the occurrence of sarcopenia and undernutrition among a nationwide community-dwelling sample of older adults. METHODS: Using a cross-sectional analysis, 1493 Portuguese older adults age ≥65 years from the Nutrition UP 65 study were evaluated. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People, and undernutrition status was evaluated by Mini-Nutritional Assessment-Short Form. RESULTS: Sarcopenia frequency was 11.6%, and of these, 4.4% were classified with severe sarcopenia. Furthermore, 0.8% presented sarcopenic obesity. Undernutrition frequency was 1.3%, and 14.7% of the older adults were classified as being at undernutrition risk. CONCLUSION: Sarcopenia is present in one-tenth of the sample. This frequency taken together with undernutrition data warrants further study and preventive measures.