Assessment of intrinsic capacity in the Brazilian older population and the psychometric properties of the WHO/ ICOPE screening tool: a multicenter cohort study protocol / Avaliação da capacidade intrínseca da população idosa brasileira e das propriedades psicométricas do instrumento de triagem do ICOPE/OMS: protocolo de estudo de coorte multicêntrico

Introduction: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce. Objectives: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool. Methods: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months. Expected results: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq). Relevance: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil. (AU)

Introdução: A Organização Mundial da Saúde (OMS) propõe o monitoramento da capacidade intrínseca (CI) da população idosa como estratégia de saúde pública por meio do Programa ICOPE (Integrated Care for Older People). Embora construído com base em conceitos sólidos, a evidência científica sobre a aplicabilidade prática da proposta ainda é escassa. Objetivo: Avaliar a capacidade intrínseca da população idosa brasileira, sua trajetória e sua associação com variáveis sociodemográficas, de saúde e desfechos. Avaliar as propriedades psicométricas da ferramenta de triagem da estratégia ICOPE da OMS. Metodologia: Coorte multicêntrica prospectiva com seguimento de 36 meses. Serão recrutadas 3.838 pessoas com 60 anos ou mais, cadastradas nas unidades de saúde incluídas no estudo pelos centros participantes. Serão coletados dados sociodemográficos e de saúde e aplicados instrumentos para avaliação dos domínios da CI, tanto aqueles previstos no instrumento de triagem do ICOPE quanto a sequência de avaliações confirmatórias previstas no programa. Os participantes serão acompanhados semestralmente ao longo de 36 meses. Resultados esperados: Estabelecer o perfil da CI na população estudada, entender a sua trajetória e as variáveis associadas aos desfechos clínicos avaliados. Revelar as propriedades diagnósticas e o perfil psicométrico da ferramenta de triagem do ICOPE da OMS. O projeto tem financiamento do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Relevância: Compreensão sobre o potencial de utilização da estratégia ICOPE de saúde pública proposta pela OMS no âmbito do Sistema Único de Saúde (SUS) pela integração de diversos centros de pesquisa científica na área de Geriatria e Gerontologia de todo o Brasil. (AU)

Cut-off points of appendicular lean soft tissue for identifying sarcopenia in the older adults in Brazil: a cross-sectional study / Puntos de corte de la masa muscular apendicular esquelética para identificar la sarcopenia en los adultos mayores de Brasil: un estudio transversal

INTRODUCTION: appropriate appendicular lean soft tissue (ALST) parameters to identify sarcopenia in Brazil are scarce. The use of international references may lead to a false positive diagnosis. The objective was to propose cut-off points to identify sarcopenia in older men and women using DXA-derived ALST values from a young adult population. METHODS: this was an observational study with a cross-sectional analysis. University students of both sexes (n = 125), aged 20 to 30 years, underwent anthropometric measurements and DXA scanning to obtain their ALST (kg). Cut-off points for sarcopenia were set at -2 standard deviations (-2SDs) away from the mean ALST of a young sample. Absolute values and index (ALST/height2, ALST/weight, and ALST/body mass index [BMI]) were considered as recommended by international consensus. RESULTS: compared to women, men presented higher values of weight, height, BMI, bone mineral content, lean soft tissue, ALST, and ALST index (kg/m²). Only fat mass was higher in women, and age was not different between genders. The -2SD ALST index obtained were = 6.56 kg/m² for men and = 4.67 kg/m² for women. They were below international and national values, which tended to classify false positives. CONCLUSIONS: the -2SD ALST values proposed here are validated cut-offs for identifying low muscle in older adults and to prevent misdiagnosis with sarcopenia. In addition, they contribute to efficient monitoring and control of this disease in geriatric populations

INTRODUCCIÓN: los parámetros apropiados de masa muscular esquelética apendicular (MMEA) para identificar la sarcopenia en Brasil resultan escasos. Ello se debe al uso de referencias internacionales, lo cual puede conducir a un diagnóstico falso positivo. El objetivo del presente trabajo es proponer puntos de corte para determinar la sarcopenia en hombres y mujeres mayores empleando valores de MMEA derivados de las DXA de una población de adultos jóvenes. MÉTODOS: estudio observacional con análisis transversal. Estudiantes universitarios de ambos sexos (n = 125), de 20 a 30 años de edad, se sometieron a mediciones antropométricas y DXA para obtener el MMEA (kg). Los puntos de corte de la sarcopenia se establecieron en -2 desviaciones estándar (-2SD) de la media de MMEA de una muestra joven. Se consideraron los valores absolutos e índices (MMEA/altura2, MMAE/ peso y MMAE/índice de masa corporal [IMC]), según lo recomendado por el consenso internacional. RESULTADOS: los hombres, en comparación con las mujeres, presentaron valores superiores de peso, altura, IMC, contenido mineral óseo, masa magra, MMEA e índice MMEA (kg/m²). Por otro lado, solo la masa grasa fue mayor en las mujeres, no habiendo diferencias de edad entre ambos géneros. El índice MMAE -2SD obtenido fue = 6,56 kg/m² para los hombres y = 4,67 kg/m² para las mujeres. Dichos resultados, al encontrarse por debajo de los valores internacionales y nacionales, tienden a clasificar los falsos positivos. CONCLUSIONES: los MMAE -2SD propuestos aquí son valores de corte validados para identificar las cuantificaciones musculares bajas en los adultos mayores y para prevenir el diagnóstico erróneo de sarcopenia. Además, contribuyen a la monitorización y el control eficiente de esta enfermedad en las poblaciones geriátricas

Cut-off points of appendicular lean soft tissue for identifying sarcopenia in older adults in Brazil: a cross-sectional study.

INTRODUCTION: Introduction: appropriate appendicular lean soft tissue (ALST) parameters to identify sarcopenia in Brazil are scarce. The use of international references may lead to a false positive diagnosis. The objective was to propose cut-off points to identify sarcopenia in older men and women using DXA-derived ALST values from a young adult population. Methods: this was an observational study with a cross-sectional analysis. University students of both sexes (n = 125), aged 20 to 30 years, underwent anthropometric measurements and DXA scanning to obtain their ALST (kg). Cut-off points for sarcopenia were set at -2 standard deviations (-2SDs) away from the mean ALST of a young sample. Absolute values and indices (ALST/height2, ALST/weight, and ALST/body mass index [BMI]) were considered as recommended by international consensus. Results: compared to women, men presented higher values of weight, height, BMI, bone mineral content, lean soft tissue, ALST, and ALST index (kg/m²). Only fat mass was higher in women, and age was not different between genders. The -2SD ALST indices obtained were ≤ 6.56 kg/m² for men and ≤ 4.67 kg/m² for women. They were below international and national values, which tended to classify false positives. Conclusions: the -2SD ALST values proposed here are validated cut-offs for identifying low muscle in older adults and to prevent misdiagnosis with sarcopenia. In addition, they contribute to efficient monitoring and control of this disease in geriatric populations.

INTRODUCCIÓN: Introducción: los parámetros apropiados de masa muscular esquelética apendicular (MMEA) para identificar la sarcopenia en Brasil resultan escasos. Ello se debe al uso de referencias internacionales, lo cual puede conducir a un diagnóstico falso positivo. El objetivo del presente trabajo es proponer puntos de corte para determinar la sarcopenia en hombres y mujeres mayores empleando valores de MMEA derivados de las DXA de una población de adultos jóvenes. Métodos: estudio observacional con análisis transversal. Estudiantes universitarios de ambos sexos (n = 125), de 20 a 30 años de edad, se sometieron a mediciones antropométricas y DXA para obtener el MMEA (kg). Los puntos de corte de la sarcopenia se establecieron en -2 desviaciones estándar (-2SD) de la media de MMEA de una muestra joven. Se consideraron los valores absolutos e índices (MMEA/altura2, MMAE/peso y MMAE/índice de masa corporal [IMC]), según lo recomendado por el consenso internacional. Resultados: los hombres, en comparación con las mujeres, presentaron valores superiores de peso, altura, IMC, contenido mineral óseo, masa magra, MMEA e índice MMEA (kg/m²). Por otro lado, solo la masa grasa fue mayor en las mujeres, no habiendo diferencias de edad entre ambos géneros. El índice MMAE -2SD obtenido fue ≤ 6,56 kg/m² para los hombres y ≤ 4,67 kg/m² para las mujeres. Dichos resultados, al encontrarse por debajo de los valores internacionales y nacionales, tienden a clasificar los falsos positivos. Conclusiones: los MMAE -2SD propuestos aquí son valores de corte validados para identificar las cuantificaciones musculares bajas en los adultos mayores y para prevenir el diagnóstico erróneo de sarcopenia. Además, contribuyen a la monitorización y el control eficiente de esta enfermedad en las poblaciones geriátricas.