Association between sarcopenia and diabetes in community dwelling elderly in the Amazon region - Viver Mais Project.

BACKGROUND: Studies indicate the intrinsic relationship between sarcopenia and diabetes mellitus (DM) pathophysiological mechanisms. Changes in insulin and muscular metabolism are features of diabetic patients and can interact as sarcopenic accelerators. Conversely, sarcopenic patients feature lower glucose tolerance and higher serum insulin levels, predisposing them to DM. OBJECTIVE: To study the association between sarcopenia and DM in a community-dwelling elderly population of the Amazon region. METHODS: Cross-sectional study, performed in Belém, Brazil, with 1078 patients aged above 60 years old from the Viver Mais Project (VMP). The definition of sarcopenia was based in the European Working Group on Sarcopenia in Older People (EWGSOP). Calf circumference >31 cm was considered normal, muscle strength was discriminated by BMI and measured with the hand grip test, and gait speed <0.8 m/s configured low performance. DM was diagnosed when reported by the patient or medical form, use of hypoglycemic medications/insulin and in the presence of fasting glucose >126 mg/dl or glycated hemoglobin (HbA1c) >6.5% on two occasions. Other medical and socio-demographic data were extracted from medical forms. RESULTS: The frequency of sarcopenia was 9.4%, while DM was present in 36.87% of the patients, and had an increased occurrence in the sarcopenic group. Female sex, advanced age, DM, coronary insufficiency, osteoporosis, body mass index, waist circumference, triglycerides and functionality were associated with sarcopenia. In multivariate analysis, sarcopenia remained strongly associated with DM (OR: 3.208, 95%CI: 1.784-5.769). CONCLUSION: This study describes strong and independent association between sarcopenia and DM. To further clarify these findings, broader prospective cohorts are necessary.

Funcionalidade global de idosos hospitalizados / Global functionality of hospitalized elderly

Objetivo: Identificar a funcionalidade global de idosos submetidos a internação, correlacionando o desempenho para as atividades de vida diária básicas (ABVD) e instrumentais (AIVD) com os principais sistemas funcionais (cognição, humor, mobilidade e comunicação). Métodos: Trata-se de estudo observacional transversal e analítico com a participação de 94 idosos internados em uma clínica médica. Os instrumentos utilizados foram: Escala de Katz, Escala de Lawton & Brody, Miniexame do Estado Mental (MEEM), Escala de Depressão Geriátrica 15 (GDS-15), Teste Timed Up and Go (TUG) e a Avaliação Funcional das Habilidades de Comunicação da Associação Americana de Fonoaudiologia (ASHA FACS). Resultados: Foram avaliados 94 idosos, cuja maioria apresentava algum grau de dependência para ABVD (61,71%) e para AIVD (52,13%). Nos sistemas funcionais, a autonomia mostrou-se preservada, com desempenho médio de 18,14 pontos no MEEM, e de 4,43 pontos na GDS-15; e a independência, alterada, por desempenho médio de 21,82 segundos no TUG, classificando-os com uma mobilidade regular, e de 5,27 pontos na ASHA FACS, considerando-os com a necessidade de auxílio moderado nessa função. Evidenciou-se moderada e significativa associação entre o desempenho para as ABVDs e AIVDs com quase todos os sistemas funcionais. Conclusão: A população estudada apresentou funcionalidade global alterada, devido a algum grau de dependência para as ABVDs e AIVDs, com autonomia preservada e independência prejudicada. As correlações evidenciaram que com o decréscimo dos principais sistemas funcionais, ocorreu declínio da funcionalidade global. .

Objective: Identify the global functionality of hospitalized elderly, correlating the performance to basic (BADL) and instrumental (IADL) activities of daily life, with the main functional systems (cognition, mood, mobility and communication). Methods: Analytical, observational, cross-sectional study, with the participation of 94 elderly patients admitted to a medical clinic. The tools used in the assessments were: the Katz Scale, Lawton and Brody Scale, Mini-Mental State Examination (MMSE), Geriatric Depression Scale 15 (GDS-15), Timed Up and Go Test (TUG) and the Functional Assessment of Communication Skills from the American Speech-Language-Hearing Association (ASHA FACS). Results: 94 elderly people were evaluated, where most had some degree of dependence for BADL (61.71%) and IADL (52.13%). In functional systems, autonomy proved to be preserved with an average performance of 18.14 points on the MMSE, and 4.43 points in the GDS-15; independence was altered, for average performance of 21.82 seconds on the TUG, classifying them with regular mobility, and 5.27 points in ASHA FACS, considering them as in need of moderate assistance in this task. It was evidenced moderate and significant association between performance for IADL and BADL in nearly all functional systems. Conclusion: The study population presented changed overall functionality, due to some degree of dependence in BADL and IADL, with preserved autonomy and impaired independence. The correlations showed that with the decline of the major functional systems occurred decline in overall functionality. .