Applicability of the SARC-F questionnaire by remote interview.

OBJECTIVE: The aim of this study was to assess the applicability of the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire by telephone to identify sarcopenia risk (SR; SARC-F ≥6) and low muscle function risk (LMFR; SARC-F ≥ 4) and their associated risk factors in a cohort of community-dwelling older adults in southern Brazil. METHODS: A longitudinal study was carried out with community-dwelling older individuals from COMO VAI? STUDY: Sociodemographic, behavioral, and health-related information were collected at baseline, and, in the second assessment, the SARC-F questionnaire was applied by phone or in-person interviews. Older adults identified with sarcopenia at the baseline assessment were excluded. Adjusted analysis by Poisson regression according to hierarchical levels was performed. RESULTS: Of the 1451 participants interviewed at baseline, only 951 participated in the second assessment. During the second assessment, 732 adults (77%) were interviewed by phone and 219 (23%) in person. There was no statistically significant difference for the SR (9.1 versus 9.7%, P = 0.802) and LMFR (22.4 versus 20.0%, P = 0.435) prevalence when the SARC-F questionnaire was administered in person or by phone, respectively. Age ≥80 y, presence of depressive symptoms, multimorbidity, dependence to perform one or more daily activities, and polypharmacy were factors associated with a higher risk for poor outcomes in older adults interviewed by phone. CONCLUSIONS: The similar prevalence between in-person and remote assessments suggests the feasibility of using the SARC-F questionnaire by phone interview as a reliable alternative for sarcopenia and low muscle function risk assessment without the requirement of face-to-face evaluations.

Accuracy of SARC-F and SARC-CalF for sarcopenia screening in older women from southern Brazil.

OBJECTIVES: The aim of this study was to verify the accuracy of the SARC-F and the SARC-CalF as screening tools for sarcopenia in community-dwelling older women ≥60 y of age. METHODS: This was a cross-sectional study evaluating a convenience sample of women ≥60 y of age, living in Southern Brazil. Sarcopenia was defined according to the criteria proposed in the latest European Working Group on Sarcopenia in Older People consensus (EWGSOP2). Appendicular muscle mass was assessed by dual-energy x-ray absorptiometry. Muscle strength was measured by handheld dynamometry, and physical performance through the 4-m gait speed test. The SARC-F questionnaire and SARC-CalF score for sarcopenia screening were also applied. RESULTS: We evaluated 288 participants, with a mean age of 67.6 ± 5.8 y. The frequency of probable and confirmed sarcopenia in the sample was 7.3% and 2.1%, respectively. The frequency of risk for sarcopenia assessed by the SARC-F was 4.5% and SARC-CalF 22.2%. Despite the excellent specificity (95.4%) demonstrated by the SARC-F, its sensitivity in identifying confirmed cases was null, whereas the SARC-CalF showed high sensitivity (83.3%) and good specificity (79%). CONCLUSION: The present study findings suggested that SARC-CalF may be able to outperform SARC-F as a sarcopenia screening tool in women ≥60 y of age even under the new EWGSOP2 criteria, the main determinant of which is strength as observed in studies based on the previous definition.

Sarcopenia in Brazilian rural and urban elderly women: Is there any difference?

OBJECTIVES: There are many studies concerning sarcopenia prevalence from all over the world. However, to our knowledge, only two compared urban and rural sarcopenia and to date, none have been conducted in the Americas. The aim of this study was to evaluate the prevalence of sarcopenia in a convenience sample of women ≥60 y of age who underwent bone densitometry and live in urban and rural areas of southern Brazil. METHODS: This was a cross-sectional study comprising 205 women ≥60 y of age who had undergone bone densitometry. Sarcopenia was defined according to the criteria recommended by the European Working Group on Sarcopenia in Older People. The diagnosis combined the evaluation of muscle mass (assessed by dual-energy x-ray absorptiometry), muscle strength (measured using a manual digital dynamometer), and muscular performance (evaluated by the 4-m walking speed test). Sociodemographic data, smoking status, chronic conditions, number of falls and fractures in the past year, and level of physical activity also were collected. RESULTS: Sarcopenia was present in 2.4% of the total sample. Urban and rural populations significantly differed in terms of schooling (P < 0.001), occupation (P = 0.010), socioeconomic status (P = 0.001), and smoking status (P = 0.006). The environment in which the women lived was independently associated with sarcopenia (odds ratio, 9.561; 95% confidence interval, 1.021-89.523; P = 0.048). The prevalence of sarcopenia was significantly higher in the urban women than in the rural group (5.7 versus 0.7%, respectively; P = 0.047). After multivariate analysis, the environment of the women's residence remained independently associated with sarcopenia. CONCLUSION: Urban elderly women are more vulnerable to sarcopenia than rural elderly women.

Falls among older adults in the South of Brazil: prevalence and determinants / Quedas em idosos no Sul do Brasil: prevalência e determinantes

ABSTRACT OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults. METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome. RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9-30.5), and most occurred in the person's own residence. Among the older adults who fell, 51.5% (95%CI 46.6-56.4) had a single fall and 12.1% (95%CI 8.9-15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis. CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

RESUMO OBJETIVO Avaliar a prevalência e os fatores associados à ocorrência de quedas em idosos. MÉTODOS Estudo transversal com amostra representativa de 1.451 idosos residentes na zona urbana de Pelotas, RS, em 2014. Foi realizada análise descritiva dos dados e apresentada a prevalência de quedas no último ano. A análise de fatores demográficos, socioeconômicos, comportamentais e de saúde associados ao desfecho foi realizada por meio de regressão de Poisson com ajuste para variância robusta conforme modelo hierárquico. As variáveis foram ajustadas entre si dentro de cada nível e para as de nível superior. Aquelas com p ≤ 0,20 foram mantidas no modelo para controle de confusão e aquelas com p < 0,05 foram consideradas associadas ao desfecho. RESULTADOS A prevalência de quedas em idosos no último ano foi de 28,1% (IC95% 25,9-30,5), e a maioria ocorreu na própria residência do idoso. Entre os idosos que sofreram queda, 51,5% (IC95% 46,6-56,4) tiveram uma única queda e 12,1% (IC95% 8,9-15,3) tiveram fratura como consequência, sendo a de membros inferiores a mais relatada. A prevalência de quedas foi maior em mulheres, idosos com idade avançada, de menor renda e escolaridade, com incapacidade funcional para atividades instrumentais e portadores de enfermidades como diabetes, doença cardíaca e artrite. CONCLUSÕES A ocorrência de quedas atingiu quase um terço dos idosos, e a prevalência foi mais elevada em segmentos específicos da população em questão. Cerca de 12% dos idosos que caíram, fraturaram algum osso. Os fatores associados à ocorrência de quedas identificados neste estudo poderão nortear medidas que visem sua prevenção na população de idosos.

Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: results of the COMO VAI? study.

BACKGROUND: There is insufficient data concerning sarcopenia prevalence in South America. The aim of this study was to estimate sarcopenia prevalence and its clinical subgroups in a Southern Brazilian city. METHODS: A cross-sectional population-based study was performed among community-dwelling elderly aged 60 years or over. Subjects were evaluated according to the European Working Group on Sarcopenia in Older People established criteria. Muscle mass was estimated by calf circumference (CC). Cut-off CC points were defined by a subsample's dual X-ray absorptiometry estimation of the appendicular skeletal muscle mass index (ASMI), which was subsequently compared with the values of a young adult population from the same city. Muscle strength was measured by manual dynamometry. Muscle performance was assessed through the 4 m gait speed test. RESULTS: The three diagnostic tests were performed in 1291 subjects. CC of ≤34 cm (males) and ≤33 cm (females) were defined as indicatives of low ASMI. The overall sarcopenia prevalence was 13.9% (CI95% 12.0; 15.8%). Its frequency was significantly higher among elderly with low schooling, without a partner, with low socioeconomic status, smokers, inactive, and with low body mass index. A higher prevalence of pre-sarcopenia was found in the youngest elderly; a higher prevalence of the clinical stages of the syndrome was found in older age groups. CONCLUSIONS: Approximately one in ten elderly aged 60-69 years was in the preclinical stage of the disease. This is the age group in which public policies should focus to establish early diagnosis and prevent clinical progression of the syndrome.