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BACKGROUND: Weight measurement is important in the nutritional anthropometric monitoring of older adults. When this measurement is not possible, estimates may be used. AIM: Developing and validating weight predictive equations for older adult residents in long-term care institutions in Brazil. SUBJECTS AND METHODS: The sample comprised 393 older adult residents in long-term care institutions. Data were collected in two stages, with 315 older adults in the first and 78 in the second. We have measured the arm, calf, and waist circumferences, as well as the triceps and subscapular skinfold and knee height. Multiple linear regression was used to develop the equations, which were evaluated through the coefficient of determination, standard error of estimation, Akaike information criterion, intraclass correlation coefficient (ICC), and Bland-Altmann plot. RESULTS: Five models with different anthropometric measurements were developed, (1) arm circumference as a discriminant variable (ICC: 0.842); (2) best statistical fit for men and women (ICC: 0.874) and its stratification by sex (3) (ICC: 0.876); (4) easy-to-perform measurement for men and women (ICC: 0.842) and its stratification by sex (5) (ICC: 0.828). CONCLUSION: Five models for estimating the weight of older adult residents in long-term care institutions were developed and validated. The choice to use the models should be based on the physical capacity of the older adults to be evaluated.
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Tejido Adiposo , Cuidados a Largo Plazo , Masculino , Humanos , Femenino , Anciano , Brasil , Antropometría , Modelos LinealesRESUMEN
INTRODUCTION: When it is impossible to measure weight in the elderly, estimation methods can be employed. However, such methods are not always applicable and can lead to estimation errors that compromise both the clinical practice and the results in epidemiological studies. OBJECTIVE: To compare and validate weight estimation methods in the elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil. METHODS: The equations were evaluated qualitatively, by the reproducibility of the measurements that comprised them, and quantitatively, by the mean difference between the measured and the estimated weights, using Student's t -test for paired samples or ANOVA, the coefficient of determination (R²), root mean square error (RMSE), intra-class correlation coefficient (ICC) and graphical analysis of residuals. The significance value adopted was of p < 0.05. It was considered applicable when the equation presented R² > 0.7; lowest RMSE among the evaluated equations; ICC > 0.7; and respective 95% confidence interval with less distance between the upper and lower limits. RESULTS: We evaluated 315 elderly from 10 nursing homes in Natal. The mean body weight was higher in the younger elderly and those without mobility restriction. The qualitative analysis showed the equation 5 as having the best reproducibility, since it does not use skinfold measurements. The quantitative analysis revealed the equation 5 as the one with the best applicability across the studied population and in the different genders, age groups (60 - 69 years, 70 - 79 years, and 80 years or more), and mobility restriction conditions. CONCLUSION: The equation 5 was applicable for estimating weight in the evaluated population and in the different strata analyzed.
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Peso Corporal , Evaluación Geriátrica/métodos , Anciano , Anciano de 80 o más Años , Tamaño Corporal , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Conceptos Matemáticos , Persona de Mediana Edad , Casas de SaludRESUMEN
RESUMO: Introdução: Na impossibilidade de mensuração do peso em idosos, métodos de estimativa podem ser empregados. Entretanto, tais métodos nem sempre são aplicáveis, podendo levar a erros de estimativa que comprometem tanto a prática clínica quanto resultados em estudos epidemiológicos. Objetivo: Comparar e validar métodos de estimativa de peso em idosos residentes em instituições de longa permanência de Natal, Rio Grande do Norte. Métodos: Avaliaram-se as equações qualitativamente pela reprodutibilidade das medidas que as compunham e, quantitativamente, pela diferença média entre o peso mensurado e os estimados, e utilizado o teste t de Student para amostras pareadas ou ANOVA, coeficiente de determinação (R²), raiz do erro quadrático médio (REQM), coeficiente de correlação intraclasse (CCI) e análise gráfica de resíduos. Adotou-se como valor de significância p < 0,05. Considerou-se aplicável quando a equação apresentava R² > 0,7; menor REQM dentre as equações avaliadas; CCI > 0,7; e respectivo intervalo de confiança 95% com menor distância entre os limites inferior e superior. Resultados: Avaliaram-se 315 idosos de 10 instituições de longa permanência de Natal. O peso corporal médio foi maior nos idosos mais jovens e sem restrição de mobilidade. A análise qualitativa mostrou a equação 5 como a de melhor reprodutilidade, uma vez que não utiliza medidas de dobras cutâneas. A análise quantitativa revelou a equação 5 como a de melhor aplicabilidade em toda a população avaliada e nos diferentes sexos, faixas etárias (60 a 69 anos, 70 a 79 anos e 80 anos ou mais) e condição de restrição de mobilidade. Conclusão: A equação 5 foi aplicável para a estimativa de peso na população avaliada e nos diferentes estratos analisados.
ABSTRACT: Introduction: When it is impossible to measure weight in the elderly, estimation methods can be employed. However, such methods are not always applicable and can lead to estimation errors that compromise both the clinical practice and the results in epidemiological studies. Objective: To compare and validate weight estimation methods in the elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil. Methods: The equations were evaluated qualitatively, by the reproducibility of the measurements that comprised them, and quantitatively, by the mean difference between the measured and the estimated weights, using Student's t -test for paired samples or ANOVA, the coefficient of determination (R²), root mean square error (RMSE), intra-class correlation coefficient (ICC) and graphical analysis of residuals. The significance value adopted was of p < 0.05. It was considered applicable when the equation presented R² > 0.7; lowest RMSE among the evaluated equations; ICC > 0.7; and respective 95% confidence interval with less distance between the upper and lower limits. Results: We evaluated 315 elderly from 10 nursing homes in Natal. The mean body weight was higher in the younger elderly and those without mobility restriction. The qualitative analysis showed the equation 5 as having the best reproducibility, since it does not use skinfold measurements. The quantitative analysis revealed the equation 5 as the one with the best applicability across the studied population and in the different genders, age groups (60 - 69 years, 70 - 79 years, and 80 years or more), and mobility restriction conditions. Conclusion: The equation 5 was applicable for estimating weight in the evaluated population and in the different strata analyzed.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Peso Corporal , Evaluación Geriátrica/métodos , Tamaño Corporal , Estudios Transversales , Conceptos Matemáticos , Casas de SaludRESUMEN
Os déficits nutricionais apresentam relação com a síndrome da fragilidade, multimorbidade e estão associados à mortalidade em idosos residentes de Instituições de Longa Permanência para Idosos (ILPI). A fim de identificar precocemente o risco de déficits, podem ser utilizadas medidas antropométricas como peso, estatura, perímetros e dobras cutâneas. Quando não é possível medir peso e estatura, podem ser estimados por equações. O presente trabalho teve o objetivo de avaliar o estado nutricional antropométrico, desenvolver e validar equações para estimativa de peso e estatura em idosos institucionalizados. O estudo foi conduzido com idosos residentes em ILPI de Natal/RN. Os dados antropométricos coletados foram peso, estatura, perímetros e dobras cutâneas. Para a análise do estado nutricional antropométrico foi realizada Análise de Componentes Principais estratificada por sexo e avaliados os escores fatoriais dos componentes extraídos em relação à faixa etária, tipo de ILPI, cor da pele, escolaridade, carga de adoecimento e restrição de mobilidade do idoso. Elaborouse equações de estimativa de peso e estatura a partir de regressão linear múltipla. Os modelos de regressão desenvolvidos levaram em consideração critérios estatísticos de confiabilidade, como o coeficiente de determinação (R²), o erro padrão de estimativa e o Critério de Informação de Akaike (AIC). As equações de predição foram validadas por testes de concordância como o Coeficiente de Correlação Intraclasse (CCI) e seu respectivo intervalo de confiança de 95%. A ACP identificou dois componentes: Estado Nutricional Antropométrico (ENA) e Estatura (E), que juntos explicaram 80,8% da variância acumulada para homens e mulheres. Em relação ao desenvolvimento das equações de estimativa de peso, foram desenvolvidos cinco modelos com diferentes medidas antropométricas: (1) utilizando o perímetro do braço como variável discriminante (Eq. Ia e Ib; CCI: 0,842), (2) com o melhor ajuste estatístico para homens e mulheres (Eq. II; CCI: 0,874), (3) e estratificado por sexo (Eq. IIIa e IIIb; CCI: 0,876), (4) com medidas de fácil realização para homens e mulheres (Eq. IV; CCI: 0,842) e (5) estratificado por sexo (Eq. Va e Vb; CCI: 0,828). Em relação à estimativa de estatura, foram desenvolvidas cinco equações com diferentes medidas antropométricas, os quais levam em consideração a altura do joelho (Eq. I; CCI: 0,863), comprimento da ulna (Eq. II; CCI: 0,766), hemi-envergadura (Eq. III; CCI: 0,815), comprimento da ulna e hemi-envergadura (Eq. IV; CCI: 0,834) e demienvergadura (Eq. V; CCI: 0,794). As diferenças observadas entre os componentes extraídos se dão especialmente entre as variáveis de restrição de mobilidade, o tipo de instituição e a escolaridade. Os idosos com mobilidade restrita, residentes em ILPI sem fins lucrativos e com menor escolaridade apresentam menores medianas de carga fatorial. Foram desenvolvidos e validados cinco modelos aplicáveis para estimativa de peso em idosos institucionalizados e cinco equações para estimativa da estatura. A escolha pela utilização das equações deve levar em consideração a possibilidade de realização de determinada medida. Foram encaminhados às ILPI participantes do estudo, relatórios com o diagnóstico nutricional dos idosos e um manual prático com as equações desenvolvidas para contribuir com o monitoramento do estado nutricional antropométrico desta população (AU).
Nutritional deficits are related to the syndrome of frailty, multimorbidity and are associated with mortality in elderly residents in nursing homes. In order to identify the risk of deficits early, anthropometric measures such as weight, height, perimeter and skinfolds may be used. When it is not possible to measure weight and height, they can be estimated by equations. This study aimed to evaluate anthropometric nutritional status, develop and validate equations for weight and height estimation in elderly residents in nursing homes. The study was conducted with elderly living in nursing homes in Brazil. The anthropometric data collected were weight, height, perimeters and skinfolds. For analyze the anthropometric nutritional status Principal Component Analysis stratified by sex was performed and the factorial scores of the chosen model were evaluated in relation to the age group, type of nursing home, racial/ethnic identity, schooling, burden of disease and functional capacity. Methods of weight and height estimation were elaborated by linear multiple regression. The regression models developed considered statistical reliability criteria, such as the coefficient of determination (R²), the standard error of the estimate and the Akaike Information Criterion (AIC). The prediction equations were validated by concordance tests such as the Intraclass Correlation Coefficient (ICC) and its respective confidence interval (95% CI). For all analyzes, p values <0.05 were considered statistically significant. CPA identified two components: Anthropometric Nutritional Status (ANS) and Stature (S), which together explained 80.8% of cumulative variance for men and women. Regarding the development of weight estimation equations, five models with different anthropometric measurements were developed: (1) using arm perimeter as discriminant variable (Eq. Ia and Ib; ICC: 0.842), (2) with the best fit statistical analysis for men and women (Eq. II; ICC: 0.874), (3) and stratified by sex (Eq. IIIa and IIIb; ICC: 0.876), (4) with easy measures for men and women (Eq. IV; ICC: 0.842) and (5) stratified by sex (Eq. Va and Vb; ICC: 0.828). Regarding height estimation, five equations were developed with different anthropometric measurements, which take into account knee height (Eq. I; ICC: 0.863), ulna length (Eq. II; ICC: 0.766), hemispan (Eq. III; ICC: 0.815), ulna length and hemispan (I Eq. V; ICC: 0.834) and demispan (Eq. V; ICC: 0.794). The differences observed between the extracted components occur especially between the mobility restriction variables, the type of nursing home and the education level. The elderly with restricted mobility, residents in nonprofit nursing homes and with less education have lower median factor loadings. Five applicable models for weight estimation in institutionalized elderly and five equations for height estimation were developed and validated. The choice of using equations should take into consideration the possibility of performing a certain measure. To nursing homes were sent reports with the nutritional assessment of the elderly and a practical manual with the equations developed by present study to contribute to the monitoring of the anthropometric nutritional status (AU).