Factors associated with sarcopenia in institutionalized elderly.

BACKGROUND: The diagnosis of sarcopenia is based on the analysis of strength, functionality and muscle mass. The objective was to verify the factors associated with sarcopenia in institutionalized elderly. METHODS: In total, 219 elderly individuals (≥60 years old) living in long-term institutions in Natal/RN were included in the study. After defining the elderly as sarcopenic or non-sarcopenic, anthropometric, biochemical, sociodemographic and health-related were analyzed. The Student t-test and Mann-Whitney test were used to analyze the quantitative, while the chi-square test was used for the qualitative variables. Finally, Poisson regression was used to provide prevalence ratios for those variables that presented differences in the bivariate analyses. RESULTS: Physical capacity and anthropometry were associated with sarcopenia. For each 1 cm of knee height, the elderly presented 2.71% more chance of not having sarcopenia, and eutrophic or overweight individuals (according to BMI) presented 37.71 and 91.81% chances, respectively, of not presenting sarcopenia. Elderly individuals who ambulate have a 30.08% chance of not being considered sarcopenic. In addition, biochemical and anthropometric indicators demonstrated a relationship of sarcopenia with malnutrition. CONCLUSION: Sarcopenia is associated with a loss of body mass, not only selective muscle mass, and greater physical inability to ambulate.

Association between low level of physical activity and mobility limitation in older adults: evidence from the SABE study.

Several studies are limited by verifying the level of physical activity with questionnaires and not through objective measurement in older adults. This article aims to analyze the association between a low level of physical activity with accelerometry) and mobility limitation in older adults. A population-based cross-sectional study conducted with 543 older adults. Multiple regression analysis was performed using hierarchical analysis, grouping the variables into two blocks ordered according to the precedence with which they acted on the outcomes. Among the evaluated older adults, 13.7% presented mobility limitations and among these 60.39% were in the low level of physical activity group. Older adults with a low level of physical activity (OR = 3.49 [2.0 - 6.13]), aged 75 and over (OR = 1.97 [1.03 - 3.72]), living without a partner (OR = 2.01 [1.09 - 3.68]), having difficulty performing basic (OR = 2.49 [1.45 - 4.28]) and instrumental (OR = 2.28) [1.18 - 4.36]) activities of daily life, and multimorbidity (OR = 2.06 [1.04 - 4.08]) were independently associated with mobility limitation. A low level of physical activity increases the chance of mobility limitation in older adults, regardless of sociodemographic and clinical variables.

Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2).

OBJECTIVE: To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. METHODS: A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. RESULTS: The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. CONCLUSION: The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.

Factors associated with inflamm-aging in institutionalized older people.

The increase in inflammatory cytokines associated with a reduction in the bioavailability of zinc has been used as a marker for inflammation. Despite the high inflammatory state found in institutionalized older individuals, few studies have proposed verifying the factors associated with this condition in this population. To verify the factors associated with inflamm-aging in institutionalized older people. A total of 178 older people (≥ 60 years old) living in nursing homes in Natal/RN were included in the study. Cluster analysis was used to identify three groups according to their inflammatory state. Analysis anthropometric, biochemical, sociodemographic, and health-related variables was carried out. In sequence, an ordinal logistic regression was performed for a confidence level of 95% in those variables with p < 0.20 in the bivariate analysis. IL-6, TNF-α, zinc, low-density lipids (LDL), high-density lipids (HDL), and triglycerides were associated with inflamm-aging. The increase of 1 unit of measurement of LDL, HDL, and triglycerides increased the chance of inflammation-aging by 1.5%, 4.1%, and 0.9%, respectively, while the oldest old (≥ 80 years old) had an 84.9% chance of presenting inflamm-aging in relation to non-long-lived older people (< 80 years). The association between biochemical markers and inflamm-aging demonstrates a relationship between endothelial injury and the inflammatory state. In addition, the presence of a greater amount of fat in the blood may present a higher relative risk of death.

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over.

OBJECTIVE: This study sought to analyze the relationship between the components and aggravations of body composition (obesity, sarcopenia, and sarcopenic obesity) and bone mineral density in elderly subjects aged ≥80 years. METHODS: A cross-sectional study design was utilized to assess 128 subjects aged between 80 and 95 years. Body composition and bone mineral density were measured by dual energy X-ray absorptiometry. Gait speed was assessment by walking test. The statistical analyses included Spearman's correlation, one-way analysis of variance, the chi-squared test, and binary logistic regression analysis. RESULTS: The elderly subjects with sarcopenia had lower bone mineral density compared to the obesity group, with higher risk for presence of osteopenia/osteoporosis in the spine (OR: 2.81; CI: 1.11-7.11) and femur (OR: 2.75; CI: 1.02-7.44). Obesity was shown to be a protective factor for osteopenia/osteoporosis in the spine (OR: 0.43; CI: 0.20-0.93) and femur (OR: 0.27; CI: 0.12-0.62). CONCLUSION: It was found that lean mass is more directly related to bone mineral density (total, femur, and spine) and sarcopenia is associated with osteopenia/osteoporosis. Obesity represents a possible protective factor for osteopenia/osteoporosis in elderly subjects aged 80 years and over.

OBJETIVO: O objetivo do presente estudo foi analisar a relação entre os componentes e agravos da composição corporal (obesidade, sarcopenia e obesidade sarcopênica) com a densidade mineral óssea em idosos com idade ≥ 80 anos. MÉTODOS: Estudo com delineamento transversal que avaliou 128 sujeitos com idade entre 80 e 95 anos. A composição corporal e densidade mineral óssea foram mensuradas por meio da técnica de absorciometria de raios X de dupla energia. A velocidade de caminhada foi avaliada pelo teste de caminhada usual. Para análise estatística foram realizados os testes de correlação de Spearman, análise de variância com um fator, teste qui-quadrado e análise de regressão logística binária. RESULTADOS: Os idosos com sarcopenia apresentaram valores menores de DMO quando comparados com o grupo obesidade com maior chance de risco para a presença de osteopenia/osteoporose na coluna (OR: 2,81; IC: 1,11-7,11) e fêmur (OR: 2,75 IC: 1,02-7,44). Obesidade apresentou fator de proteção para osteopenia/osteoporose na coluna (OR: 0,43; IC: 0,20-0,93) e fêmur (OR: 0,27; IC: 0,12-0,62). CONCLUSÃO: Observou-se que a massa magra está diretamente relacionada com a DMO (total, fêmur e coluna) e que a sarcopenia está associada à osteopenia/osteoporose em idosos com 80 anos ou mais.

Association between low level of physical activity and mobility limitation in older adults: evidence from the SABE study / Associação entre baixo nível de atividade física e limitação de mobilidade em idoso: evidência do estudo SABE

Abstract Several studies are limited by verifying the level of physical activity with questionnaires and not through objective measurement in older adults. This article aims to analyze the association between a low level of physical activity with accelerometry) and mobility limitation in older adults. A population-based cross-sectional study conducted with 543 older adults. Multiple regression analysis was performed using hierarchical analysis, grouping the variables into two blocks ordered according to the precedence with which they acted on the outcomes. Among the evaluated older adults, 13.7% presented mobility limitations and among these 60.39% were in the low level of physical activity group. Older adults with a low level of physical activity (OR = 3.49 [2.0 - 6.13]), aged 75 and over (OR = 1.97 [1.03 - 3.72]), living without a partner (OR = 2.01 [1.09 - 3.68]), having difficulty performing basic (OR = 2.49 [1.45 - 4.28]) and instrumental (OR = 2.28) [1.18 - 4.36]) activities of daily life, and multimorbidity (OR = 2.06 [1.04 - 4.08]) were independently associated with mobility limitation. A low level of physical activity increases the chance of mobility limitation in older adults, regardless of sociodemographic and clinical variables.

Resumo Vários estudos são limitados por meio da verificação do nível de atividade física com questionários, mas não possuem medidas objetivas em adultos mais velhos. O objetivo deste artigo é analisar a associação entre um baixo nível de atividade física e limitação de mobilidade em idosos. Um estudo transversal de base populacional realizado com 543 idosos. A análise múltipla da regressão foi realizada usando a análise hierárquica, agrupando as variáveis em dois blocos ordenados de acordo com a precedência com que atuaram sobre os resultados. Entre os idosos avaliados, 13,7% apresentaram limitações de mobilidade e entre estes 60,39% estavam no baixo nível de atividade física. Idosos com um baixo nível de atividade física (OR = 3,49 [2,0 - 6,13]), com idade igual ou superior a 75 anos (OR = 1,97 [1,03 - 3,72]), vivendo sem parceiro (OR = 2,01 [1,09 - 3,68]), dificuldade de viver sem um parceiro (OR = 2,01 [1,09 - 3,68]), dificuldades com atividades básicas (OR = 2,49 [1,45 - 4,28]) e as atividades instrumentais (OR = 2.28) [1.18 - 4.36]) atividades da vida do dia a dia e multimobilidade (OR = 2,06 [1,04 - 4,08]) foram associadas independentemente à mobilidade. Um baixo nível de atividade física aumenta a possibilidade de limitação da mobilidade em adultos idosos, independentemente das variáveis sociodemográficas e clínicas.

Analysis of relationship of high fat mass and low muscle mass with lipid profile in Brazilians aged 80 years or over.

AIM: To analyze the lipid profile of older people aged ≥80 years according to body composition (high fat mass, low muscle mass and both). MATERIAL AND METHOD: The sample consisted of 113 older people aged ≥80 years. The assessment of body composition was made using Dual Energy X-ray Absorptiometry (DXA) and the lipid profile analysis using an enzymatic colorimetric kit. We used Analysis of Variance (ANOVA) test to compare the mean of lipid profile according to body composition and were constructed logistic regression models to verify the association between these two variables. RESULTS: It was found that older people with high fat had higher mean values of TG compared to normal and low muscle mass group. Older people with low muscle mass showed mean values of LDL-c lower than other groups. It was observed that older people with high fat is more likely to have (OR 2.70; 95%CI 1.14-6.37) high blood concentration of TG. CONCLUSION: Thus, it appears that high fat is related to the high blood concentration of TG in older people aged ≥80 years, especially those with Asian origin and diabetes besides those with low muscle mass shows lower mean values of LDL-c.

Obesity, sarcopenia, sarcopenic obesity and reduced mobility in Brazilian older people aged 80 years and over.

OBJECTIVE: To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. METHODS: The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to indicate an association between obesity, sarcopenia, sarcopenic obesity and mobility. Binary logistic regression, adjusted for the variables (sex and osteoarticular diseases), was used to express the magnitude of these associations. One-way analysis of variance was used to compare the mobility of four groups (Normal, Obesity, Sarcopenia and Sarcopenic Obesity). RESULTS: The Sarcopenia Group had lower performance in the lower limbs strength test and in sum of two tests compared with Obesity and Normal Groups. Older people with sarcopenia had higher chance of reduced mobility (OR: 3.44; 95%CI: 1.12-10.52). CONCLUSION: Older people aged 80 years and older with sarcopenia have more chance for reduction in mobility.

Osteoarticular diseases and physical performance of Brazilians over 80 years old.

OBJECTIVE: To investigate the physical performance of Brazilian individuals older than 80 years with and without OD. METHODS: The sample consisted of 135 individuals (aged > 80 years) of both gender. Identification of osteopenia/osteoporosis was verified by Dual Energy X-ray Absorptiometry, and the presence of others osteoarticular diseases (OD) was obtained using a questionnaire of morbidities. Physical performance was analyzed by motor tests. RESULTS: Men presented higher proportion of osteopenia/osteoporosis compared to women (p = 0.013). The proportion of older people with arthritis/osteoarthritis for women and men was 33% and 26%, respectively, and with OD in the spine was 19% and 12%, respectively. No significant difference for physical performance, measured by each test and overall score, was observed between groups of OD. According to gender, male with OD presented lower performance in gait speed, balance and overall score (p < 0.05), while older people with osteopenia/osteoporosis are at higher risk for low physical performance (OR 2.73; CI 95% 1.31-5.66). CONCLUSION: In conclusion it was verified in older people with age of 80 years or more, a high prevalence of OD, especially in men, and the presence of these diseases interfered negatively their physical performance.

Comparison of the printed and online administration of the Behavioral Regulation in Exercise Questionnaire (BREQ-2) / Comparação da administração impressa e on-line do Behavioral Regulation in Exercise Questionnaire (BREQ-2)

ABSTRACT Objective: To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. Methods: A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. Results: The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. Conclusion: The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.

RESUMO Objetivo: Comparar a forma tradicional impressa do Behavioral Regulation in Exercise Questionnaire com uma proposta de formulário on-line, em termos de validade, confiabilidade e aplicabilidade. Métodos: Estudo de delineamento cruzado (crossover) realizado com 157 estudantes universitários de graduação. Metade da amostra respondeu primeiro ao questionário impresso e, 7 dias depois, ao questionário on-line, enquanto a outra metade da amostra fez o inverso. O coeficiente alfa de Cronbach foi usado para analisar a consistência interna dos questionários on-line e impressos. A validade de construção foi verificada por análise fatorial confirmatória, utilizando-se um estimador de mínimos quadrados ajustados pela média e variância e rotação oblíqua. A qualidade do modelo foi testada com índices de ajuste. Resultados: A análise fatorial confirmatória mostrou a estrutura de 19 itens com cinco fatores: χ2 de 230,718; graus de liberdade de 142; χ2/grau de liberdade de 1,625; índice de ajuste comparativo de 0,978 e raiz do erro quadrático médio de aproximação de 0,073. Todos os itens apresentaram cargas fatoriais acima de 0,5. Também houve excelente consistência entre os formatos de administração em todas as dimensões, com valores de alfa de Cronbach acima de 0,70. A estabilidade entre os formatos de administração variou entre 0,78 (IC95%: 0,69-0,85) e 0,84 (IC95%: 0,77-0,89), sugerindo confiança desejável entre os dois formatos de administração. Conclusão: O modelo de cinco fatores do Behavioral Regulation in Exercise Questionnaire on-line apresenta consistência interna tanto em relação às dimensões da escala quanto em relação ao total de itens.

Prevalence and factors associated to physical inactivity in elderly brazilians evaluated by accelerometry: evidence from the sabe study / Prevalência e fatores associados à inatividade física em idosos brasileiros avaliados pela acelerometria: evidências do estudo sabe

Background: Population studies using accelerometers to estimate physical inactivity in older people have been carried out in developed countries. In Brazil, these studies are limited to subjective measures. Objective: to identify through an accelerometer the prevalence and factors associated with physical inactivity in older people residents in São Paulo, Brazil. Methods: This is a cross-sectional population-base study conducted with 543 older people individuals (mean 73.8 years) using data from the SABE study (Health, Welfare and Ageing). The level of physical activity was measured using accelerometers, and the participants categorized into inactive with <30 minutes of moderate and/or vigorous activity daily; and active with > 30 minutes moderate and/or vigorous activity daily. The independent variables were sociodemographic, anthropometric, clinical, and lifestyle. The association of the dependent variable with the independent variables was conducted using multiple regression analysis. Results: Of the older people evaluated, 85.4% were physically inactive (men = 74.3% and women = 91.9%). Older people aged >75 years (OR=4.67 [1.87 to 11.66]), women (OR=2.26 [1.15 to 4.44]), with high waist circumference (OR=2.93 [1.41 to 6.12]), high number of comorbidities (OR=2.27 [1.22 to 4.23]), and chronic pain (OR=2.54 [1.32 to 4.88]) were associated independently with physical inactivity. Conclusion: The prevalence of physical inactivity in older people individuals aged 65 or over is appalling and associated with sociodemographic, anthropometric, and clinical variables.(AU)

Estudos populacionais utilizando acelerômetros para estimar a inatividade física em idosos têm sido realizados em países desenvolvidos. No Brasil, esses estudos se limitam a medidas subjetivas. Objetivo: identificar por meio de um acelerômetro a prevalência e os fatores associados à inatividade física em idosos residentes em São Paulo, Brasil. Métodos: Trata-se de um estudo transversal de base populacional realizado com 543 idosos (média de 73,8 anos) a partir dos dados do estudo SABE (Saúde, Bem-Estar e Envelhecimento). O nível de atividade física foi medido por meio de acelerômetros, e os participantes categorizados em inativos com <30 minutos de atividade moderada e / ou vigorosa diariamente; e ativo com> 30 minutos de atividade moderada e / ou vigorosa diariamente. As variáveis independentes foram sociodemográficas, antropométricas, clínicas e estilo de vida. A associação da variável dependente com as variáveis independentes foi realizada por meio de análise de regressão múltipla. Resultados: Dos idosos avaliados, 85,4% eram inativos fisicamente (homens = 74,3% e mulheres = 91,9%). Idosos com idade> 75 anos (OR = 4,67 [1,87 a 11,66]), mulheres (OR = 2,26 [1,15 a 4,44]), com circunferência da cintura elevada (OR = 2,93 [1,41 a 6,12]), elevado número de comorbidades (OR = 2,27 [1,22 a 4,23]) e dor crônica (OR = 2,54 [1,32 a 4,88]) foram associados de forma independente à inatividade física. Conclusão: A prevalência de inatividade física em idosos com 65 anos ou mais é preocupante e está associada a variáveis sociodemográficas, antropométricas e clínicas.(AU)

Short-term changes in handgrip strength, body composition, and lymphedema induced by breast cancer surgery.

PURPOSE: This study investigated short-term changes in body composition, handgrip strength, and presence of lymphedema in women who underwent breast cancer surgery. METHODS: Ninety-five women participated in a cross-sectional study, divided into two groups: Control (n=46), with healthy women, and Experimental (n=49), with women six months after breast cancer surgery. The Experimental Group was subdivided into right total mastectomy (RTM, n=15), left total mastectomy (LTM, n=11), right quadrant (RQ, n=13), and left quadrant (LQ, n=10). It was also redistributed among women with presence (n=10) or absence (n=39) of lymphedema. Presence of lymphedema, handgrip strength, and body composition were assessed. RESULTS: Trunk lean mass and handgrip strength were decreased in the Experimental Group. Total lean mass was increased in the LTM compared to RTM or LQ. Left handgrip strength in LTM was decreased compared to RTM and RQ and in LQ compared to RTM and RQ. Finally, total lean mass, trunk fat mass, trunk lean mass, right and left arm lean mass were increased in women with lymphedema. CONCLUSIONS: Breast cancer survivors have changes in their body composition and in handgrip strength six months after surgery; however, the interaction between the type of surgery and its impact is unclear. Furthermore, women who developed lymphedema in this period showed more significant changes in the body composition, but they were not enough to cause impairment in handgrip strength.

Association between bone mass and functional capacity among elderly people aged 80 years and over.

OBJECTIVE: Analyzed the association of bone mass with the functional capacity of elderly aged 80 or more. METHODS: The sample consisted of 93 elderly aged 80 and 91 years (83.2±2.5 years) being 61 women (83.3±2.7 years) and 32 men (83.1±2.2 years) living in the city of Presidente Prudente - São Paulo/Brazil. The assessment of bone mass was realized by absorptiometry dual-energy X-ray (DXA), where have been measured values bone mineral content (BMC) and bone mineral density (BMD) of the femur and spine (L1-L4). The functional capacity was evaluated by means of walking speed tests, static equilibrium and strength of lower limbs contained in the questionnaire Wellness Health and Aging (SABE). The variables of bone mass and functional capacity were categorized according to the median values and score tests, respectively. For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. RESULTS: Elderly male with higher performance in the functional tests showed higher femur BMC compared to lower performance, result not found when evaluated women. CONCLUSION: Thus, the bone of the femur for the oldest old male is associated with functional capacity. The constant assessment of the bone mineral mass and practive of physical activity throughout life would be measures to prevent falls in the elderly.

OBJETIVO: Analisar a associação entre a massa óssea e capacidade funcional de idosos com 80 anos ou mais. MÉTODOS: A amostra foi composta por 93 idosos entre 80 e 91 anos (83,2±2,5 anos), 61 mulheres (83,3±2,7 anos) e 32 homens (83,1±2,2 anos) da cidade de Presidente Prudente. A avaliação da massa óssea foi feita pela absorptiometria de dupla energia de raios X (DXA), na qual foram mensurados os valores de conteúdo mineral ósseo (BMC) e densidade mineral óssea (BMD) do fêmur e da coluna (L1­L4). A capacidade funcional foi avaliada por meio dos testes de velocidade para caminhar, equilíbrio estático e força de membros inferiores contidos no questionário Saúde, Bem-Estar e Envelhecimento (Sabe). As variáveis da massa óssea e capacidade funcional foram categorizadas de acordo com os valores de mediana e a pontuação obtida nos testes, respectivamente. Para tratamento estatístico fez-se o teste qui-quadrado, o software usado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%. RESULTADOS: Os idosos do sexo masculino com maior desempenho nos testes funcionais apresentaram maiores valores de BMC de fêmur comparados com os de menor desempenho, resultado não encontrado quando avaliadas as mulheres. CONCLUSÃO: Dessa forma, a massa óssea do fêmur para idosos longevos do sexo masculino está associada à capacidade funcional. A avaliação constante da massa mineral óssea e a prática de atividade física ao longo da vida seriam medidas para prevenção das quedas em idosos.

The most frequent cardiovascular risk factors in Brazilian aged 80 years or older.

To identify the most frequent cardiovascular risk factors (CRFs) in Brazilian participants. Sample of 113 individuals aged 80 to 95 years (83.4 + 2.9 years), of both sexes, from Presidente Prudente, São Paulo state. Waist circumference (WC), body mass index, percentage of total body fat (% BF), hypertension, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and glucose were used for characterization of risk factors. The chi-square test was used to assess proportions of risk factors and Student's t test to compare the results between the sexes. High prevalence of risk factor was observed, mainly hypertension (67.3%) and % BF (79.6%). Male participants presented higher weight, height, and WC (p < .001), and female participants, higher TC and % BF (p < .001). Only 7.1% of male and 4.2% of female participants showed no risk factors, and 71.3% of male and 85.9% of female participants had three or more. The participants presented a high prevalence of CRFs, particularly percentage of body fat and hypertension, and, in addition, female participants also presented TC.

Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over / Relação entre obesidade, sarcopenia, obesidade sarcopênica e densidade mineral óssea em idosos com 80 anos ou mais

ABSTRACT Objective This study sought to analyze the relationship between the components and aggravations of body composition (obesity, sarcopenia, and sarcopenic obesity) and bone mineral density in elderly subjects aged ≥80 years. Methods A cross-sectional study design was utilized to assess 128 subjects aged between 80 and 95 years. Body composition and bone mineral density were measured by dual energy X-ray absorptiometry. Gait speed was assessment by walking test. The statistical analyses included Spearman's correlation, one-way analysis of variance, the chi-squared test, and binary logistic regression analysis. Results The elderly subjects with sarcopenia had lower bone mineral density compared to the obesity group, with higher risk for presence of osteopenia/osteoporosis in the spine (OR: 2.81; CI: 1.11-7.11) and femur (OR: 2.75; CI: 1.02-7.44). Obesity was shown to be a protective factor for osteopenia/osteoporosis in the spine (OR: 0.43; CI: 0.20-0.93) and femur (OR: 0.27; CI: 0.12-0.62). Conclusion It was found that lean mass is more directly related to bone mineral density (total, femur, and spine) and sarcopenia is associated with osteopenia/osteoporosis. Obesity represents a possible protective factor for osteopenia/osteoporosis in elderly subjects aged 80 years and over.

RESUMO Objetivo Analisar a relação entre os componentes e agravos da composição corporal (obesidade, sarcopenia e obesidade sarcopênica) com a densidade mineral óssea em idosos com idade ≥ 80 anos. Métodos Estudo com delineamento transversal que avaliou 128 sujeitos entre 80 e 95 anos. A composição corporal e densidade mineral óssea foram mensuradas por meio da técnica de absorciometria de raios X de dupla energia. A velocidade de caminhada foi avaliada pelo teste de caminhada usual. Para análise estatística foram feitos os testes de correlação de Spearman, análise de variância com um fator, teste qui-quadrado e análise de regressão logística binária. Resultados Os idosos com sarcopenia apresentaram valores menores de DMO quando comparados com o grupo obesidade com maior chance de risco para a presença de osteopenia/osteoporose na coluna (OR: 2,81; IC: 1,11-7,11) e fêmur (OR: 2,75 IC: 1,02-7,44). Obesidade apresentou fator de proteção para osteopenia/osteoporose na coluna (OR: 0,43; IC: 0,20-0,93) e fêmur (OR: 0,27; IC: 0,12-0,62). Conclusão Observou-se que a massa magra está diretamente relacionada com a DMO (total, fêmur e coluna) e que a sarcopenia está associada à osteopenia/osteoporose em idosos com 80 anos ou mais.

Factors associated with mobility of the oldest old / Fatores associados à mobilidade de idosos longevos

Abstract Introduction: Several factors can be associated to the reduction of mobility among the elderly. Early identification of these factors is crucial, since it may lead to prevention of functional dependencies. Objective: To analyze the association between mobility, sociodemographic factors and the prevalence of noncommunicable chronic diseases (NCDs) in oldest old. Methods: The sample consisted of 120 elderly persons aged (80 and 95 years), with 76 of them being women (83 ± 3 years) and 44 of them men (83 ± 3 years). Sociodemographic factors and NCDs which we studied were: age, gender, marital status, education, nutritional status, ethnicity, hypertension, diabetes and osteoarticular diseases. Mobility was analyzed using a battery of Physical Performance Tests. For statistical analysis we used the chi-square test and binary logistic regression to examine the relationship between sociodemographic factors, NCDs and mobility. SPSS (17.0) software was used for this and the significance level was set at 5%. Results: Level of education (p ≤ 0.001) and age (p = 0.034) are the two factors related to low mobility. However, the model built by multiple logistic regression analysis revealed that age is independently related to limited mobility in oldest old people (OR 3.29; 95% CI 1.09 to 9.87). Conclusion: Thus, oldest old >85 years are at a greater risk of decreased mobility independent of their education, marital and nutritional statuses and gender. We encourage further studies in this area. Studies which will not only address those facts considered in this study but that also examine family-related aspects, especially using longitudinal studies.

Resumo Introdução: A redução da mobilidade pode estar relacionada a vários fatores e a identificação precoce desses fatores torna-se fundamental, uma vez que pode auxiliar na prevenção da dependência funcional de idosos. Objetivo: analisar a relação entre mobilidade, fatores sociodemográficos e prevalência de doenças crônicas não transmissíveis (DCNT) em idosos longevos. Métodos: A amostra foi constituída por 120 idosos com idade entre 80 e 95 anos (83 ± 3 anos), sendo 76 mulheres (83 ± 3 anos) e 44 homens (83 ± 3 anos). Os fatores sociodemográficos e DCNT investigados foram: idade, sexo, estado civil, escolaridade, etnia, estado nutricional, hipertensão, diabetes e doenças osteoarticulares. A mobilidade foi analisada por meio da bateria Physical Perfomance Tests. Para tratamento estatístico foram empregados os testes qui-quadrado e regressão logística binária para analisar a associação entre fatores sociodemográficos, DCNT e a mobilidade. O software utilizado foi o SPSS (17.0) e o nível de significância estabelecido foi de 5%. Resultados: Os fatores relacionados à baixa mobilidade foram a escolaridade (p ≤ 0,001) e idade (p = 0,034). Contudo, o modelo múltiplo construído pela análise de regressão logística revelou que a idade está independentemente relacionada à limitação da mobilidade em idosos longevos (OR 3,29; IC95% 1,09-9,87). Conclusão: Dessa forma, idosos longevos com idade >85 anos apresentam mais chance de risco para limitação da mobilidade independente da escolaridade, dos estados civil e nutricional, e do sexo. Incentiva-se a futuros estudos além de abordar os aspectos trabalhados no presente estudo, averiguar também aspectos familiares, e principalmente, em estudos longitudinais.

Obesity, sarcopenia, sarcopenic obesity and reduced mobility in Brazilian older people aged 80 years and over / Obesidade, sarcopenia, obesidade sarcopênica e mobilidade reduzida em idosos brasileiros com 80 anos ou mais

ABSTRACT Objective: To analyze which abnormalities in body composition (obesity, sarcopenia or sarcopenic obesity) are related to reduced mobility in older people aged 80 years and older. Methods: The sample included 116 subjects aged 80 years and older. The body composition was measured using dual-energy X-ray absorptiometry (DXA) and mobility was assessed by motor tests. The χ2 test was used to analyze the proportion of older people with sarcopenia, obesity and sarcopenic obesity based on sex as well as to indicate an association between obesity, sarcopenia, sarcopenic obesity and mobility. Binary logistic regression, adjusted for the variables (sex and osteoarticular diseases), was used to express the magnitude of these associations. One-way analysis of variance was used to compare the mobility of four groups (Normal, Obesity, Sarcopenia and Sarcopenic Obesity). Results: The Sarcopenia Group had lower performance in the lower limbs strength test and in sum of two tests compared with Obesity and Normal Groups. Older people with sarcopenia had higher chance of reduced mobility (OR: 3.44; 95%CI: 1.12-10.52). Conclusion: Older people aged 80 years and older with sarcopenia have more chance for reduction in mobility.

RESUMO Objetivo: Analisar quais agravos na composição corporal (obesidade, sarcopenia ou obesidade sarcopênica) estão relacionados à redução da mobilidade em idosos com 80 anos ou mais. Métodos: A amostra foi constituída por 116 sujeitos com idade igual ou superior a 80 anos. A composição corporal foi mensurada pela técnica de absorciometria de raios X de dupla energia (DXA), e a mobilidade foi avaliada por testes motores. O teste χ2foi utilizado para analisar a proporção de idosos com sarcopenia, obesidade e obesidade sarcopênica, de acordo com o sexo, bem como para indicar a associação entre obesidade, sarcopenia, obesidade sarcopênica e mobilidade. A análise de regressão logística binária, ajustada pelas variáveis (sexo e doenças osteoarticulares), foi utilizada para expressar a magnitude das associações. A análise de variância foi usada para comparar a mobilidade entre os quatro grupos (Normal, Obesidade, Sarcopenia e Obesidade Sarcopênica). Resultados: O Grupo Sarcopenia apresentou menor desempenho no teste de força de membros inferiores e na soma dos dois testes, comparado aos Grupos Obesidade e Normal. Idosos com sarcopenia apresentaram maior chance de redução da mobilidade (OR: 3,44; IC95%: 1,12-10,52). Conclusão: Idosos com idade igual ou superior a 80 anos com sarcopenia têm mais chance de redução da mobilidade.

NÍVEL DE ATIVIDADE FÍSICA, POR ACELEROMETRIA, EM IDOSOS DO MUNICÍPIO DE SÃO PAULO: ESTUDO SABE / PHYSICAL ACTIVITY LEVEL, BY ACCELEROMETRY, IN SÃO PAULO'S ELDERLY PEOPLE: SABE STUDY / NIVEL DE ACTIVIDAD FÍSICA, POR ACELEROMETRIA, DE LÓS ANCIANOS DE LA CIUDAD DE SÃO PAULO: ESTUDIO SABE

Introdução: Estudos populacionais utilizam, geralmente, métodos indiretos de estimativa do nível de atividade física (NAF) da população. Entretanto, o erro de medida, principalmente quando se trata da população idosa, é grande. Estudos nacionais que usam medidas objetivas são escassos. Objetivo: Este estudo buscou descrever o perfil de prática de atividade física (AF) da população idosa do município de São Paulo utilizando-se acelerometria. Métodos: Este trabalho faz parte do estudo SABE, desenvolvido na capital do Estado de São Paulo e analisou os dados de 568 idosos (≥ 65 anos). O acelerômetro da marca Actigraph foi utilizado durante 3 dias consecutivos. Os idosos foram classificados segundo o NAF de acordo com as recomendações atuais de AF. O NAF foi descrito (média e IC 95%) segundo sexo e grupos etários (< 70 anos, 70 a 79 anos e ≥ 80 anos). As proporções de idosos em cada grupo de NAF foram descritas em termos relativos (%). As diferenças entre os grupos foram estimadas utilizando-se o teste generalizado de igualdade entre médias de Wald. Resultados: Os idosos considerados sedentários representaram 63,1% (48,3% dos homens e 71,7% das mulheres) e apresentaram média de idade maior; houve prevalência de 25,7% dos homens e 8,13% das mulheres classificados como fisicamente ativos, o que corresponde a apenas 14,6% do total de idosos. Os idosos gastam, em média, 12,6 (IC 95% 10,6 - 13,7) minutos por dia em atividades físicas consideradas de intensidade moderada e/ou vigorosa. A proporção de idosos fisicamente ativos é menor quanto maior for a idade. Conclusão: O NAF da população idosa do Município de São Paulo é baixo e considerado insuficiente, principalmente para o sexo feminino. Assim, houve maior proporção de idosos considerados sedentários e insuficientemente ativos quando comparados aos ativos.

Introduction: Population studies generally use indirect methods to estimate the physical activity level (PAL). However, the measurement error, particularly when it comes to the elderly, is significant. National studies using objective measures are scarce. Objective: This study aimed to describe the physical activity level of the elderly in São Paulo city using accelerometry. Methods: This research is part of SABE Study carried out in the capital of São Paulo and analyzed data of 568 elderly people (≥65 years). The Actigraph accelerometer was used for three consecutive days. The elderly were classified according to the PAL in accordance with the current recommendations of PA. The PAL was described (mean and 95% CI) by sex and age groups (< 70 years, 70-79 years and ≥ 80 years). The proportion of elderly people in each PAL group was described in relative terms (%). Differences between groups were estimated using Wald test. Results: Elderly classified as sedentary accounted for 63.1% (48.3% men and 71.7% women) and had higher mean age; prevalence was 25.7% of men and 8.13% of women classified as physically active, which corresponds to only 14.6% of the elderly. The elderly spend on average 12.6 (95% CI 10.6 to 13.7) minutes per day in physical activity considered moderate and/or vigorous. The proportion of elderly individuals active is smaller the greater the age. Conclusion: The PAL of elderly population of São Paulo city is low and insufficient, especially among women. Thus, the proportion of elderly people considered sedentary and insufficiently active were greater compared to physically active elderly people.

Introducción: Los estudios de población suelen utilizar métodos indirectos para estimar el nivel de actividad física (NAF) de la población. Sin embargo, el error de medición, especialmente en el caso de la población de edad avanzada, es grande. Estudios nacionales utilizando medidas objetivas son escasos. Objetivo: Este estudio trata de describir el perfil de actividad física (AF) de la población de ancianos en la ciudad de São Paulo mediante acelerometría. Métodos: Este trabajo forma parte del estudio SABE, llevado a cabo en la capital de São Paulo y analizó los datos de 568 personas de edad avanzada (≥ 65 años). Se utilizó el acelerómetro Actigraph durante tres días consecutivos. Los ancianos fueron clasificados de acuerdo al NAF según las recomendaciones de AF actuales. El NAF fue descrito (media e IC 95%) por sexo y grupos de edad (< 70 años, 70-79 años y ≥ 80 años). La proporción de personas mayores en cada grupo de NAF fue descrita en términos relativos (%).Las diferencias entre los grupos se calcularon utilizando la prueba de Wald. Resultados: Ancianos considerados sedentarios representan el 63,1% (48,3% hombres y 71,7% mujeres) y tuvieron mayor media de edad; la prevalencia fue del 25,7% de los hombres y el 8,13% de las mujeres clasificados como físicamente activos, lo que corresponde a sólo el 14,6% de las personas mayores. Los ancianos gastan en promedio 12,6 (IC del 95%: 10,6 a 13,7) minutos por día en actividad física considerada moderada y/o vigorosa. La proporción de ancianos físicamente activos disminuye a medida que aumenta la edad. Conclusión: El NAF de la población anciana de São Paulo es considerado bajo e insuficiente, especialmente para las mujeres. Por lo tanto, hubo una mayor proporción de personas de edad avanzada considerada sedentaria e insuficientemente activa en comparación con los activos.

Osteoarticular diseases and physical performance of Brazilians over 80 years old / Doenças osteoarticulares e desempenho físicode idosos brasileiros com idade igual ou superior a 80 anos

Abstract Objective To investigate the physical performance of Brazilian individuals older than 80 years with and without OD. Methods The sample consisted of 135 individuals (aged > 80 years) of both gender. Identification of osteopenia/osteoporosis was verified by Dual Energy X-ray Absorptiometry, and the presence of others osteoarticular diseases (OD) was obtained using a questionnaire of morbidities. Physical performance was analyzed by motor tests. Results Men presented higher proportion of osteopenia/osteoporosis compared to women (p = 0.013). The proportion of older people with arthritis/osteoarthritis for women and men was 33% and 26%, respectively, and with OD in the spine was 19% and 12%, respectively. No significant difference for physical performance, measured by each test and overall score, was observed between groups of OD. According to gender, male with OD presented lower performance in gait speed, balance and overall score (p < 0.05), while older people with osteopenia/osteoporosis are at higher risk for low physical performance (OR 2.73; CI 95% 1.31-5.66). Conclusion In conclusion it was verified in older people with age of 80 years or more, a high prevalence of OD, especially in men, and the presence of these diseases interfered negatively their physical performance.

Resumo Objetivo Investigar o desempenho físico de idosos brasileiros com idade superior a 80 anos com e sem doenças osteoarticulares (DO). Métodos Foram avaliados 135 indivíduos (idade > 80 anos) de ambos os sexos. A presença de osteoporose foi analisada por meio da técnica de Absorptiometria de Raios-X de Dupla Energia, e a prevalência de outras doenças osteoarticulares foi verificada por meio de um questionário resumido de morbidades referidas. O desempenho físico foi avaliado por testes motores. Resultados Os homens apresentaram maior proporção de osteopenia/osteoporose comparados às mulheres (p = 0,013). A proporção de idosos com artrite/artrose foi 33% e 26%, e com alguma doença na coluna foi 19% e 12%, para homens e mulheres, respectivamente. Não houve diferença significativa no desempenho físico para a amostra geral. Segundo o sexo, homens com DO apresentaram menor desempenho nos testes de caminhada, equilíbrio e escore total (p < 0,05). Idosos com osteopenia/osteoporose apresentaram maior risco para limitação física (OR 2,73; IC 95% 1,31-5,66). Conclusão Foi verificado em idosos com idade igual ou superior a 80 anos alta prevalência de doenças osteoarticulares, especialmente em homens, e sua presença interfere negativamente no desempenho físico.

Factors associated with sarcopenia in subjects aged 80 years and over / Fatores associados à sarcopenia em idosos longevos

OBJECTIVE: To analyze whether sarcopenia is associated with sociodemographic factors and chronic noncommunicable diseases in adults aged 80 years and older. METHODS: The sample consisted of 120 adults aged 80 to 95 years (83.4±2.9 years) from the city of Presidente Prudente (São Paulo, Brazil), of which 76 were females (83.4±3.0 years) and 44 were males (83.4±2.6 years). The study sociodemographic and epidemiological factors were: age stratum, gender, marital status, education level, chronic noncommunicable diseases, ethnicity, and nutritional status. Body composition was determined by Dual-Energy X-Ray Absorptiometry and sarcopenia was identified by the appendicular lean mass ratio (upper limb lean mass + lower limb lean mass [kg]/height [m]2). The Chi-square test analyzed whether sarcopenia was associated with sociodemographic and epidemiological factors and binary logistic regression expressed the magnitude of the associations. The data were treated by the software Statistical Package for the Social Sciences (17.0) at a significance level of 5%. RESULTS: The factors associated with sarcopenia were gender, age, nutritional status, and osteopenia/osteoporosis. CONCLUSION: The factors gender, age, nutritional status, and osteopenia/osteoporosis are independently associated with sarcopenia in adults aged 80 years and older. .

OBJETIVO: Analisar a associação entre sarcopenia, fatores sociodemográficos e doenças crônicas não transmissíveis em idosos longevos. MÉTODOS: A amostra foi constituída por 120 idosos - 76 mulheres (83,4±3,0 anos) e 44 homens (83,4±2,6 anos) -, com idade entre 80 e 95 anos (83,4±2,9 anos), residentes na cidade de Presidente Prudente (SP), Brasil. Os fatores sociodemográficos e epidemiológicos investigados foram: estrato etário, sexo, estado civil, escolaridade, doenças crônicas não transmissíveis, etnia e estado nutricional. A análise da composição corporal foi feita pela técnica de absorptiometria de raios-X de dupla energia, e, para identificação da sarcopenia, foi utilizada a razão da massa apendicular (massa magra dos membros superiores mais massa magra dos membros inferiores [kg]/estatura [m]2). Para tratamento estatístico, foi empregado o teste Qui-quadrado para analisar a associação entre os fatores sociodemográficos, epidemiológicos e sarcopenia, e a análise de regressão logística binária foi utilizada para expressar a magnitude das associações. Foi utilizado o software Statistical Package for the Social Sciences (17.0), e o nível de significância estabelecido foi de 5%. RESULTADOS: Os fatores que se associaram com a sarcopenia foram: sexo, idade, estado nutricional, osteopenia/osteoporose. CONCLUSÃO: O sexo, a idade, o estado nutricional e a presença de osteopenia/osteoporose são fatores que estão independentemente associados à sarcopenia em idosos longevos. .