Factors associated with frailty syndrome in older adults with three- and four-criteria clustering.

This study aimed to identify the main clusters of diagnostic criteria pertaining to frailty syndrome as well as the factors associated with the occurrence of frailty without diagnostic criteria clusters and with clusters of three and four criteria. This is a cross-sectional study, carried out with 216 older adults. In order to determine the dependent variable, a combination of the following criteria for frailty syndrome diagnostic criteria was used: unintentional weight loss, exhaustion, muscle weakness, a low level of physical activity, and a slow gait speed. There were different clusters of Frailty Syndrome diagnostic criteria and were associated with Frailty with clustering of three criteria, age group ≥80 years and negative self-perception of health and Frailty with clustering of four criteria, age group ≥80 years and polypharmacy use. Age, self-perception of health, and polypharmacy can be assessed to target different intervention plans in the frail older adult population.

Motor performance tests as screening instruments for frailty in the older adults.

OBJECTIVE: To verify the association between frailty and motor performance, and identify which test is the best predictor of frailty in the older adults. METHODS: Cross-sectional, population- and home-based study that analyzed data from 286 older adults. The association between physical performance tests and frailty was verified by binary logistic regression. The diagnostic power of the performance tests and the identification of the best cut-off points to frailty were evaluated using the ROC curve and the area under the ROC curve. RESULTS: The prevalence of frailty was 23.8%. Frailty was associated with worse performances in the 'chair stand' test (p=<0.01) and the 'pick up a pen' test (p=<0.01). Performance requiring more than 14 seconds in the 'chair stand' test proved to be a good criterion for discriminating frailty in the older adults, considering the sensitivity and specificity. CONCLUSION: The worst performances in the tests were associated with the frailty syndrome. All tests were able to predict frailty in the older adults. However, taking into account the high sensitivity of the use of the 'pick up a pen' test to confirm a diagnosis of frailty (84.6%), this is recommended for use in home environments.

Determinants of falls in community-dwelling elderly: hierarchical analysis.

OBJECTIVE: To analyze the fall-related factors in community-dwelling elderly. DESIGN AND SAMPLE: Epidemiologic cross-sectional population-based household study with hierarchical interrelationships among the potential risk factors. The sample was made up of noninstitutionalized individuals over age 60, who were resident of a city in Brazil's Northeast Region. MEASURES: The dependent variable was fall occurrence in the last 12 months; independent variables were sociodemographic, behavioral, health, and functional status factors. Multivariate hierarchical Poisson regression analysis was used based on a proposed theoretic model. RESULTS: Three hundred and sixteen (89.0%) elderly participated of the survey, average age 74.2 years; the majority was female, with limited literacy and had low-medium family income. The fall prevalence was of 25.8%; occurrence was related to depression symptoms (PR = 1.55) and balance limitation (PR = 1.56). CONCLUSIONS: The high fall prevalence among elderly necessitates the identification of fall-related factors for action planning prevention programs with this group.

Anthropometric indicators of obesity as screening tools for high blood pressure in the elderly.

The study objectives were to investigate the indicators of obesity most associated with high blood pressure in community-dwelling elderly and identify among these which one best discriminates high blood pressure. This is an epidemiological, population, cross-sectional and home-based study of elderly people (≥ 60 years, n = 316) residing in northeastern Brazil. The results showed that the body mass index and the body adiposity index were the indicators more closely associated with high blood pressure in both sexes. Both in female and male genders, body mass index showed high values of specificity and low sensitivity values for discriminating high blood pressure, whereas the body adiposity index showed high sensitivity and moderate specificity values. In clinical practice and health surveillance, it is suggested that both indicators be used as screening tools for hypertension in the elderly.

Relationship between BMI and physical performance among older adults.

Our objective was to examine the relationship between body mass index (BMI) and physical performance in community-dwelling older adults. This was a descriptive and association study, based on secondary data derived from a population-based epidemiological research involving 316 older adults. The BMI was thus classified: <22.0 kg/m(2), underweight; 22.0 ≤ BMI ≤ 27.0 kg/m(2), adequate; >27.0 kg/m(2), overweight. Physical performance was assessed based on "chair stand", "pick up a pen" and walking tests. Associations between BMI and performance at each test were tested by Cox regression for survival analysis with multiple modeling adjusted by gender and age, adopting a significance level of 5% (α = 0.05). Individuals with underweight (ßadjusted = 0.64; p = 0.004), performed poorly in the "chair stand" test when compared to individuals with adequate weight. The BMI was a predictor of good physical function, with underweight being more of a limiting factor than overweight.

[Motor performance of the elderly in northeast Brazil: differences with age and sex]. / Desempenho motor de idosos do Nordeste brasileiro: diferenças entre idade e sexo.

The aim of this study was to examine motor performance according to sex and age group in community-dwelling elderly individuals of the Brazilian Northeast. This was a cross-sectional study, which analyzed data of 316 elderly individuals from a population-based household epidemiological survey performed in January 2011. Participants of the study included 173 women (54.7%) and 143 men with an mean age of 74.2 ± 9.8 years. Women presented higher functional decline due to aging and more functional limitations in strength/endurance tests in lower members and locomotion. In both sexes, the prevalence of functional limitation was higher in the age groups 70-79 years and > 80 years, with women showing more limitation after age 70 and men after age 80. Data from this study can aid the planning of interventions for prevention, maintenance or improvement of functional limitation in older people, providing more integrated care.

Analysis of Plantar Tactile Sensitivity in Older Women after Conventional Proprioceptive Training and Exergame.

OBJECTIVE: To evaluate and compare the effects of conventional proprioceptive training and games with motion monitoring on plantar tactile sensitivity in older women. METHODS: A randomized controlled clinical trial, with 50 older women randomized into three groups: conventional proprioception (n = 17), games with motion monitoring (n = 16), and the control (n = 17). They underwent 24 intervention sessions, three times a week, for eight weeks. The conventional proprioception group performed exercises involving gait, balance, and proprioception. The games performed by the motion monitoring group included exercises using the Xbox Kinect One video game from Microsoft®. The evaluation of tactile pressure sensitivity was performed using Semmes-Weinstein monofilaments. Intragroup comparisons between the two paired samples were performed using paired Student's t-test or Wilcoxon test. Intergroup comparisons between the three independent samples were performed using the Kruskal-Wallis test and Dunn's post hoc test, with p ≤ 0.05. RESULTS: The older women submitted to conventional games with motion monitoring training and showed improvement in plantar tactile sensitivity in the right and left feet. When comparing the intergroup results, the two training modalities obtained an improvement in the plantar tactile sensitivity of the older women when compared to the control group. CONCLUSIONS: We conclude that both training modalities may favor the improvement of plantar tactile sensitivity in older women, with no significant differences between conventional and virtual training.

[Maximum expiratory pressure is a good predictor of the incidence of the frailty syndrome in elderly men]. / Pressão expiratória máxima é boa preditora de incidência da síndrome de fragilidade em homens idosos.

This article aims to investigate the association between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with the incidence of frailty syndrome (FS), in addition to testing the predictive ability of MIP and MEP to discriminate FS in elderly adults, according to sex. It is a longitudinal study with a five-year follow-up period (2014-2019), carried out with 104 elderly adults registered in the Family Health Strategy of a municipality in Bahia. The incidence of frailty syndrome was diagnosed according to criteria proposed by Fried et al., using data from 2019, after a five-year follow-up. The MIP and MEP were evaluated according to the recommendations of the Brazilian Society of Pulmonology and Phthisiology data in 2014 (baseline data). The total incidence of frailty syndrome was 16.3% (95%CI: 9.2-23.6), with 13.6% (95%CI: 4.56-22.55) in women and 20% (95%CI: 7.85-32.15) in men. The mean values of MIP and MEP were, respectively, 60,8±21,2 cmH2O and 76,7±23,1 cmH2O in women, and 79,5±27,0 cmH2O and 114,7±29,8 cmH2O in men. The frailty syndrome was associated with MEP in elderly adult men (adjusted RR: 0.96; 95%CI: 0.95-0.98; P-value: 0.002), indicating that the increase of 1cmH2O in MEP reduces by 4% the risk of developing the syndrome.

O objetivo deste artigo é investigar a associação entre a Pressão Inspiratória Máxima (PImáx) e Pressão Expiratória Máxima (PEmáx) com a incidência da síndrome de fragilidade (SF), além de testar a capacidade preditiva da PImáx e PEmáx em discriminar a SF em idosos, de acordo com o sexo. Estudo longitudinal com cinco anos de seguimento (2014-2019), realizado com 104 idosos cadastrados na Estratégia Saúde da Família de um município da Bahia. A incidência da síndrome de fragilidade foi diagnosticada de acordo os critérios propostos por Fried et al., utilizando dados de 2019, após cinco anos de seguimento. A PImáx e PEmáx foram avaliadas conforme recomendações da Sociedade Brasileira de Pneumologia e Tisiologia em 2014 (linha de base). A incidência total da SF foi de 16,3% (IC95%: 9,2-23,6), sendo 13,6% (IC95%: 4,56-22,55) no sexo feminino e 20,0% (IC95%: 7,85-32,15) no sexo masculino. Os valores médios da PImáx e PEmáx foram, respectivamente, 60,8±21,2 cmH2O e 76,7±23,1 cmH2O no sexo feminino, e 79,5±27,0 cmH2Oe 114,7±29,8 cmH2O no sexo masculino. A SF esteve associada à PEmáx em idosos do sexo masculino (RR ajustado: 0,96; IC95%: 0,95-0,98; p-valor: 0,002), indicando que o aumento de 1 cmH2O da PEmáx reduz em 4% o risco de desenvolver a síndrome de fragilidade.

Are maximum respiratory pressures predictors of sarcopenia in the elderly?

OBJECTIVE: To compare maximum respiratory pressures and spirometric parameters among elderly individuals classified as having no sarcopenia, probable sarcopenia, and confirmed sarcopenia, and to test the ability of these variables to discriminate sarcopenia in a community-dwelling elderly population. METHODS: This was a cross-sectional study involving 221 elderly (≥ 60 years of age) individuals of both sexes. Sarcopenia was diagnosed in accordance with the new consensus of the European Working Group on Sarcopenia in Older People. Maximum respiratory pressures and spirometry parameters were assessed. RESULTS: The prevalences of probable sarcopenia and confirmed sarcopenia were 20.4% and 4.1%, respectively. Regardless of the sex, those with confirmed sarcopenia had significantly lower MEP than those with no sarcopenia and probable sarcopenia, whereas only males with confirmed sarcopenia presented with significantly lower MIP than did the other individuals. There was an inverse association of MIP and MEP with sarcopenia, indicating that the decrease by 1 cmH2O in these parameters increases the chance of sarcopenia by 8% and 7%, respectively. Spirometric parameters were not associated with sarcopenia. Cutoff points for MIP and MEP, respectively, were ≤ 46 cmH2O and ≤ 50 cmH2O for elderly women, whereas they were ≤ 63 cmH2O and ≤ 92 cmH2O for elderly men, and both were identified as predictors of sarcopenia (area under the ROC curve > 0.70). CONCLUSIONS: Sarcopenia was associated with lower maximum respiratory pressures, but not with spirometric parameters. Maximum respiratory pressures can be used as markers of sarcopenia in a community-dwelling elderly population regardless of the sex.

Factors influencing gait speed in community-dwelling older women: A Bayesian approach.

BACKGROUND: Human gait is a complex task resulting from the interaction of sensory perception, muscle force output, and sensory-motor integration, which declines with the aging process and impacts gait speed in older women. RESEARCH QUESTION: What are the separate and combined impacts of sensory-motor factors on gait speed of older women? METHODS: Sixty healthy older women (69.3 ±â€¯5.9 years) volunteered for this study. A previous screening using Pearson's correlation selected variables significantly correlated with gait speed: age, plantar tactile perception, lower limb explosive force, and mean velocity (MV) of the center of pressure (CoP). Simple and multivariate regression models were performed with selected variables. The magnitude of evidence was obtained using Bayesian inference, determining posterior probabilities based on our data. RESULTS: Gait speed was negatively correlated with age and positively correlated with plantar tactile perception, MV (Romberg index), and lower limb explosive force. The coefficient of determination (R2) varied between 0.06 for plantar tactile perception and 0.22 for explosive force (p < 0.05). The multivariate model, including age, MV (Romberg index), and lower limb explosive force, explained 44% (R2 = 0.44) of the variance in gait speed, with a small standard error of estimate (0.14 m/s). Bayesian inference confirmed the good posterior probability of the model. SIGNIFICANCE: Age, plantar tactile perception, MV (Romberg index), and lower limb explosive force impact gait speed, whereas the combination of the first three factors has an excellent posterior probability of predicting or affecting gait speed.

Anthropometric indicators as screening tools for sarcopenia in older adult women.

OBJECTIVE: To investigate the association between sarcopenia and different anthropometric indicators, and identify the best indicator to discriminate sarcopenia in community-dwelling older adult women. METHOD: Data from 173 older adult women (≥60 years), living in Lafaiete Coutinho, a small-sized city in northeastern Brazil, were analyzed. Sarcopenia was defined based on the European consensus on definition and diagnosis using three components: muscle mass, muscle strength and performance. The association between sarcopenia and anthropometric indicators (body mass index, corrected arm muscle area and calf perimeter) was tested using the binary logistic regression technique. RESULTS: The adjusted regression model indicated that all anthropometric indicators were inversely associated with sarcopenia, and an increase by one unit in body mass index, corrected arm muscle area or calf circumference decreased the probability of sarcopenia in older adult women by approximately 85%, 16% and 72%, respectively. CONCLUSION: All the studied anthropometric indicators can be used as discriminators of sarcopenia in an older adult women population. To this end body mass index exhibited better sensitivity and calf circumference better specificity. The results of the study may improve nursing practice and that of other healthcare professionals, enabling sarcopenia screening in older adult women from simple and low-cost anthropometric indicators.

Impact of the psychosocial aspects of work on the quality of life of teachers.

OBJECTIVE: To investigate the impact of psychosocial aspects on the quality of life of teachers from municipal schools in Natal, Brazil. METHOD: descriptive study with a cross-sectional design and a sample of 242 elementary school teachers. We used the WHOQOL-bref to assess the quality of life as well as questions about the level of control and the psychological demand of work from the Job Content Questionnaire. RESULTS: the overall evaluation of quality of life showed that the physical and environmental domains had the lowest mean scores. According to the psychosocial aspects, most of the subjects (67 individuals = 32.1%) were characterized as having active work (high demand and control), followed by 54 teachers (25.8%) with demanding work (high demand and little control). These two groups have shown to be more affected in the assessment of physical (p < 0.001), psychological (p < 0.001), and environment (p < 0.001) domains of quality of life. CONCLUSIONS: Teachers who had tasks characterized as active and demanding were more affected in the quality of life domain. This finding suggests the need for greater investment in health-promotion policies among teachers.

Prevalence and factors associated with hypertriglyceridemic waist in the elderly: a population-based study.

To identify the prevalence and factors associated with hypertriglyceridemic waist (HW) in community-dwelling elderly people in northeast Brazil. Population-based cross-sectional study. Some 316 elderly (≥ 60 years) people of both sexes participated in this study. Data were collected using a questionnaire, based on that used in the Health, Welfare and Aging Study (SABE), in addition to blood tests, blood pressure measurements and anthropometric measurements. The hypertriglyceridemic waist condition was diagnosed using high values of triglycerides (≥ 150 mg/dl) and waist circumference increased ≥ 88 and ≥ 102 cm for women and men, respectively. Logistic regression analysis was used to compare the hypertriglyceridemic waist and associated factors, significance level of 5%. The prevalence of hypertriglyceridemic waist (HW) was 27.1%. The logistic regression model (OR) adjusted showed the condition of HW associated to the feminine sex (OR 4.19), to the insufficiently active elderly (OR 2.41) and with overweight (OR 4.06). A high prevalence (27.1%) of hypertriglyceridemic waist was observed, indicating the female sex, physical inactivity and overweight as key factors associated with hypertriglyceridemic waist in community-dwelling elderly people.

Age and mini-mental state examination score can predict poor-quality spirometry in the elderly: a cross-sectional study.

OBJECTIVES: The goal was to identify predictors of poor-quality spirometry in community-dwelling older adults and their respective cutoffs. METHODS: This was a cross-sectional population-based study involving 245 elderly subjects (age≥60 years). The spirometric data were categorized as good or poor quality, and cognitive status was assessed using an adapted version (scaled to have a maximum of 19 points) of the Mini-Mental State Examination. Multivariate analysis was used to assess the association between poor-quality spirometry and sociodemographic, behavioral and health characteristics. The best cutoff points for predicting poor-quality spirometry were evaluated by the receiver operating characteristic curve. RESULTS: In this population, 61 (24.9%) subjects with poor-quality spirometry were identified. After multiple logistic regression analysis, only age and Mini-Mental State Examination score were still associated with poor-quality spirometry (p≤0.05). The cutoff for the Mini-Mental State Examination score was 15 points, with an area under the receiver operating characteristic curve of 0.628 (p=0.0017), sensitivity of 74.5% and specificity of 49.5%; for age, the cutoff was 78 years, with an area under the receiver operating characteristic curve of 0.718 (p=0.0001), sensitivity of 57.4% and specificity of 79.9%. CONCLUSION: Age and Mini-Mental State Examination score together are good predictors of poor-quality spirometry and can contribute to the screening of community-dwelling older adults unable to meet the minimum quality criteria for a spirometric test.

Reduced functional capacity of community-dwelling elderly: a longitudinal study. / Redução da capacidade funcional de idosos residentes em comunidade: estudo longitudinal.

This study aimed to identify the incidence and risk factors for the reduced functional capacity of community-dwelling elderly. A prospective, two-stage cohort study was conducted in 2011 and 2014. The study population consisted of 202 initially independent older adults for the basic activities of daily living. The relative risk (RR) and its respective 95% confidence intervals (CI) were used as a measure of association and were estimated by log-binomial regression with robust variance. The incidence of lower functional capacity was 15.3%. The risk factors for the functional decline were unmarried status (RRadj = 2.75; 95%CI: 1.15-6.57) and depressive symptoms (RRadj = 2.41; 95%CI: 1.15-5.06), even after adjusting for gender, age group, per capita household income, diabetes, use of medication and level of physical activity. The high incidence of reduced functional capacity and its association with marital status and mental health aspects reveals the need to consider such factors in the planning of health actions aimed at maintaining and restoring the functional capacity of the seniors.

O objetivo deste estudo foi identificar a incidência e fatores de risco para a redução da capacidade funcional de idosos residentes em comunidade. Foi conduzido estudo de coorte prospectivo em duas fases, 2011 e 2014. A população do estudo foi composta por 202 idosos inicialmente independentes para as atividades básicas da vida diária. Utilizou-se como medida de associação o risco relativo (RR) e seus respectivos intervalos de confiança (IC) 95%, que foram estimados por regressão log-binomial com variância robusta. A incidência da redução de capacidade funcional foi de 15,3%. Os fatores de risco para o declínio funcional foram: estado civil sem união (RR aj = 2,75; IC95%: 1,15 ­ 6,57) e presença de sintomas de depressão (RR aj = 2,41; IC95%: 1,15 ­ 5,06), mesmo após ajuste por sexo, faixa etária, renda familiar per capita, diabetes, uso de medicamentos e nível de atividade física. A elevada incidência da redução de capacidade funcional e sua associação com aspectos da relação conjugal e de saúde mental revela a necessidade de considerar tais fatores no planejamento de ações em saúde voltadas à manutenção e recuperação da capacidade funcional dos idosos.

Parâmetros espirométricos podem predizer a incidência de fragilidade em pessoas idosas? / Can spirometric parameters predict the incidence of frailty in the elderly people?

Objetivo: Verificar a associação entre indicadores espirométricos e a incidência da síndrome de fragilidade em pessoas idosas. Métodos: Trata-se de um estudo com delineamento longitudinal realizado em 2014-2019, com uma amostra de estudo de 104 pessoas idosas. A variável dependente foi a síndrome de fragilidade, avaliada por meio do fenótipo de Fried et al. e as variáveis independentes foram os indicadores espirométricos, sendo eles a Capacidade Vital Forçada (CVF), Pico de Fluxo Expiratório (PFE), Volume Expiratório Forçado no primeiro segundo (VEF1), relação VEF1/CVF e o Fluxo Expiratório Forçado 25%-75% (FEF25-75%). Resultados: A incidência de pessoas idosas frágeis foi de 16,3% em ambos os sexos, sendo que o sexo masculino apresentou melhores indicadores de função pulmonar que as mulheres. Apesar disso, observamos que não houve associação entre a síndrome de fragilidade e os indicadores espirométricos (p>0,05). Conclusão: Os indicadores espirométricos não são preditores de fragilidade em pessoas idosas residentes na comunidade, após cinco anos de seguimento.

Objective: To verify the association between spirometric indicators and the incidence of frailty syndrome in elderly people. Methods: This is a study with a longitudinal design carried out in 2014-2019, with a study sample of 104 elderly people. The dependent variable was the frailty syndrome, assessed using the phenotype of Fried et al. and the independent variables were the spirometric indicators, namely Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio and Forced Expiratory Flow 25%-75 % (FEF25-75%). Results: The incidence of frail elderly people was 16.3% in both genders, with males presenting better lung function indicators than females. Despite this, we observed that there was no association between the frailty syndrome and the spirometric indicators (p>0.05). Conclusion: Spirometric indicators are not predictors of frailty in community-dwelling elderly people after five years of follow-up.

[Anthropometric indicators as predictors in determining frailty in elderly people]. / Indicadores antropométricos como preditores na determinação da fragilidade em idosos.

The scope of this article is to analyze anthropometric indicators as predictors in determining frailty in elderly people. This is a cross-sectional, family-based and analytical study. The survey was composed of 316 elderly subjects. The association between the anthropometric markers and frailty was tested using the Logistic Regression technique. However, the power of frailty diagnosis using anthropometric markers and the identification of the best cutoff points were evaluated using the parameters provided by the Receiver Operating Characteristic (ROC) curve. The anthropometric indicators of nutritional status: calf circumference, body mass index and corrected arm-muscle area are inversely associated with frailty. Thus, an increase in the values of these indicators is a protective factor against this syndrome. Analyzing body mass index and calf circumference simultaneously in order to perform a simpler screening for frail elderly people is recommended, as these indicators show good sensitivity and are easier to measure.

O objetivo deste artigo é analisar Os indicadores antropométricos como preditores na determinação da fragilidade em idosos. Trata-se de um estudo transversal de base domiciliar e analítico. A pesquisa foi constituída por 316 idosos. A associação entre os marcadores antropométricos e a fragilidade foi testada por meio da técnica de Regressão Logística. Já o poder de diagnóstico de fragilidade, utilizando os marcadores antropométricos e a identificação dos melhores pontos de corte, foi avaliado por meio dos parâmetros fornecidos pela curva Receiver Operating Characteristic. Os indicadores antropométricos de estado nutricional, Perímetro da Panturrilha, Índice de Massa Corpórea e Área Muscular do Braço Corrigida, são inversamente associados à fragilidade, assim o incremento nos valores desses indicadores é fator de proteção para esta síndrome. Recomenda-se que o Perímetro da Panturrilha e o Índice de Massa Corpórea sejam analisados de forma combinada para realizar de forma ainda mais simples a triagem de idosos frágeis, já que possuem boa sensibilidade e têm maior facilidade de mensuração de seus valores.

Pressão expiratória máxima é boa preditora de incidência da síndrome de fragilidade em homens idosos / Maximum expiratory pressure is a good predictor of the incidence of the frailty syndrome in elderly men

Resumo O objetivo deste artigo é investigar a associação entre a Pressão Inspiratória Máxima (PImáx) e Pressão Expiratória Máxima (PEmáx) com a incidência da síndrome de fragilidade (SF), além de testar a capacidade preditiva da PImáx e PEmáx em discriminar a SF em idosos, de acordo com o sexo. Estudo longitudinal com cinco anos de seguimento (2014-2019), realizado com 104 idosos cadastrados na Estratégia Saúde da Família de um município da Bahia. A incidência da síndrome de fragilidade foi diagnosticada de acordo os critérios propostos por Fried et al., utilizando dados de 2019, após cinco anos de seguimento. A PImáx e PEmáx foram avaliadas conforme recomendações da Sociedade Brasileira de Pneumologia e Tisiologia em 2014 (linha de base). A incidência total da SF foi de 16,3% (IC95%: 9,2-23,6), sendo 13,6% (IC95%: 4,56-22,55) no sexo feminino e 20,0% (IC95%: 7,85-32,15) no sexo masculino. Os valores médios da PImáx e PEmáx foram, respectivamente, 60,8±21,2 cmH2O e 76,7±23,1 cmH2O no sexo feminino, e 79,5±27,0 cmH2Oe 114,7±29,8 cmH2O no sexo masculino. A SF esteve associada à PEmáx em idosos do sexo masculino (RR ajustado: 0,96; IC95%: 0,95-0,98; p-valor: 0,002), indicando que o aumento de 1 cmH2O da PEmáx reduz em 4% o risco de desenvolver a síndrome de fragilidade.

Abstract This article aims to investigate the association between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with the incidence of frailty syndrome (FS), in addition to testing the predictive ability of MIP and MEP to discriminate FS in elderly adults, according to sex. It is a longitudinal study with a five-year follow-up period (2014-2019), carried out with 104 elderly adults registered in the Family Health Strategy of a municipality in Bahia. The incidence of frailty syndrome was diagnosed according to criteria proposed by Fried et al., using data from 2019, after a five-year follow-up. The MIP and MEP were evaluated according to the recommendations of the Brazilian Society of Pulmonology and Phthisiology data in 2014 (baseline data). The total incidence of frailty syndrome was 16.3% (95%CI: 9.2-23.6), with 13.6% (95%CI: 4.56-22.55) in women and 20% (95%CI: 7.85-32.15) in men. The mean values of MIP and MEP were, respectively, 60,8±21,2 cmH2O and 76,7±23,1 cmH2O in women, and 79,5±27,0 cmH2O and 114,7±29,8 cmH2O in men. The frailty syndrome was associated with MEP in elderly adult men (adjusted RR: 0.96; 95%CI: 0.95-0.98; P-value: 0.002), indicating that the increase of 1cmH2O in MEP reduces by 4% the risk of developing the syndrome.

Anthropometric indicators as predictors of dynapenia in postmenopausal women

Abstract Aim: Anthropometry represents an alternative to the evaluation of nutritional status and screening of events related to muscle fitness. Therefore, this study aimed to compare anthropometric indicators of postmenopausal women with and without dynapenia and to identify the predictive capacity of these indicators to screen the respective outcome in this population. Methods: Cross-sectional epidemiological study, conducted with postmenopausal women. Dynapenia was diagnosed by handgrip strength < 20 kgf. Arm (AC), abdominal (AbC), hip (HC) and calf circumferences (CC), triceps, biceps, subscapular, supraspinatus and thigh skinfolds were analyzed. Body Mass Index, Conicity Index (CI), Body Adiposity Index (BAI), Waist to Hip and Waist to Height Ratio (WHtR), Corrected Arm Muscle Area (CAMA) and Arm Muscle Circumference (AMC) were calculated. Results: A total of 273 women participated in the study. The BAI, WHtR, and CI did not present significant differences between the groups. For the other indicators, the dynapenic group obtained significantly lower values compared to the non-dynapenic. AC was the indicator with the highest sensitivity to screen for postmenopausal dynapenia (79.8%). While CAMA and AMC were the indicators with the best specificity (86.2%). However, CC showed the best balance between sensitivity (67.5%) and specificity (63.0%). Conclusion: The indicators AC, CAMA, and/or the AMC can be used together, or CC alone, to predict postmenopausal women with dynapenia. Therefore, these indicators can be used as important epidemiological tools to improve women's health surveillance actions.

Are maximum respiratory pressures predictors of sarcopenia in the elderly? / Pressões respiratórias máximas são preditores de sarcopenia em idosos?

ABSTRACT Objective: To compare maximum respiratory pressures and spirometric parameters among elderly individuals classified as having no sarcopenia, probable sarcopenia, and confirmed sarcopenia, and to test the ability of these variables to discriminate sarcopenia in a community-dwelling elderly population. Methods: This was a cross-sectional study involving 221 elderly (≥ 60 years of age) individuals of both sexes. Sarcopenia was diagnosed in accordance with the new consensus of the European Working Group on Sarcopenia in Older People. Maximum respiratory pressures and spirometry parameters were assessed. Results: The prevalences of probable sarcopenia and confirmed sarcopenia were 20.4% and 4.1%, respectively. Regardless of the sex, those with confirmed sarcopenia had significantly lower MEP than those with no sarcopenia and probable sarcopenia, whereas only males with confirmed sarcopenia presented with significantly lower MIP than did the other individuals. There was an inverse association of MIP and MEP with sarcopenia, indicating that the decrease by 1 cmH2O in these parameters increases the chance of sarcopenia by 8% and 7%, respectively. Spirometric parameters were not associated with sarcopenia. Cutoff points for MIP and MEP, respectively, were ≤ 46 cmH2O and ≤ 50 cmH2O for elderly women, whereas they were ≤ 63 cmH2O and ≤ 92 cmH2O for elderly men, and both were identified as predictors of sarcopenia (area under the ROC curve > 0.70). Conclusions: Sarcopenia was associated with lower maximum respiratory pressures, but not with spirometric parameters. Maximum respiratory pressures can be used as markers of sarcopenia in a community-dwelling elderly population regardless of the sex.

RESUMO Objetivo: Comparar as pressões respiratórias máximas e parâmetros espirométricos entre idosos classificados como sem sarcopenia, sarcopenia provável e sarcopenia confirmada e testar a capacidade dessas variáveis de discriminar sarcopenia em idosos residentes em comunidade. Métodos: Estudo transversal envolvendo 221 idosos (≥ 60 anos) de ambos os sexos. Sarcopenia foi diagnosticada de acordo com o novo consenso do Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas. As pressões respiratórias máximas e parâmetros espirométricos foram avaliados. Resultados: As prevalências de sarcopenia provável e sarcopenia confirmada foram de 20,4% e 4,1%, respectivamente. Independentemente do sexo, aqueles com sarcopenia confirmada apresentaram PEmáx significativamente menor do que aqueles sem sarcopenia e provável sarcopenia, enquanto apenas os homens com sarcopenia confirmada apresentaram PImáx significativamente menor do que os outros indivíduos. Houve uma associação inversa de PImáx e PEmáx com sarcopenia, indicando que a diminuição de 1 cmH2O nesses parâmetros aumenta a chance de sarcopenia em 8% e 7%, respectivamente. Os parâmetros espirométricos não foram associados à sarcopenia. Os pontos de corte para PImáx e PEmáx, respectivamente, foram ≤ 46 cmH2O e ≤ 50 cmH2O para mulheres idosas, enquanto foram ≤ 63 cmH2O e ≤ 92 cmH2O para homens idosos, e ambas foram identificadas como preditores de sarcopenia (ASC ROC > 0,70). Conclusões: A sarcopenia associou-se a pressões respiratórias máximas mais baixas, mas não a parâmetros espirométricos. As pressões respiratórias máximas podem ser usadas como marcadores de sarcopenia em idosos residentes em comunidade, independentemente do sexo.