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.

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.

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.

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.

[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.

Prevalence and factors associated with dynapenia in older women using different diagnostic criteria

Abstract Aim: This study aimed to identify the prevalence and factors associated with dynapenia in older women, considering different cutoff points as diagnostic criteria. Methods: This epidemiological study was conducted with 205 older women (72.7 ± 7.1 years). Dynapenia was diagnosed using the handgrip strength test (HGS) using two cutoff points (< 16 or < 20 kgf). Socio-demographic, behavioral, and health status information was obtained from a specific form; nutritional status was assessed by body mass index, and the International Physical Activity Questionnaire identified the level of physical activity. Results: The prevalence of dynapenia was 14.1% (HGS < 16 kgf) and 46.3% (HGS < 20 kgf) (p < 0.001). It was also observed that older women with family income ≤ 1 minimum wage and those with low weight presented, respectively, 2.22 (95%CI: 1.12-4.39) and 4.72 (95%CI: 1.64-13.58) times higher probability of dynapenia identified by HGS < 16 kgf. Moreover, for the cutoff point < 20 kgf, the probability of dynapenia was higher in women aged ≥ 80 years (PR:1.91; 95%CI: 1.23-2.95), in insufficiently active women (PR: 1.34; 95%CI: 1.01-2.57), among those with low weight (PR: 1.61; 95%CI: 1.01-2.57), and in those who reported falls (PR:1.42; 95%CI: 1.04-1.96). Conclusion: Therefore, it is concluded that there is a difference between the prevalence and factors associated with dynapenia when different cutoff points are adopted.

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.

Efeito do treinamento combinado sobre a pressão arterial de idosos hipertensos: uma revisão sistemática / Effect of combined training on hypertensive blood pressure of hypertensive elderly: a systematic review

O objetivo desta revisão sistemática foi analisar o efeito do treinamento combinado na pressão arterial de idosos hipertensos. As buscas foram realizadas em novembro de 2021 nas bases de dados: National library of medicine, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scopus. Os critérios de inclusão foram: ensaios clínicos randomizados; população com idade ≥60 anos e com diagnóstico de hipertensão arterial; exercício combinado como intervenção; pressão arterial como um dos desfechos; publicados no idioma inglês e/ou português entre 2007 e 2021 e disponíveis em texto completo. Após as buscas, foram identificados 991 artigos científicos. Destes, 9 estudos foram selecionados por atenderam ao objetivo e aos critérios propostos. O tamanho das amostras variou de 20-115 participantes, com média de 48,7 ± 29,8. Todos os estudos foram conduzidos com idosos; 44,4% foram realizados com população somente do sexo feminino e 22,2% dos estudos com população do sexo masculino. No que se refere ao período de realização da intervenção, observou-se que o treinamento combinado foi executado desde uma única sessão até 16 semanas, numa frequência de três vezes por semana. Os estudos apontaram que após a realização do treinamento combinado, ocorreram reduções significativas nos valores de pressão arterial sistólica e diastólica. Apesar do treinamento combinado ter contribuído significativamente para reduzir os valores de pressão arterial, os resultados desta revisão sistemática devem ser interpretados com cautela, devido ao pequeno número de artigos inclusos e de suas respectivas limitações metodológicas. (AU)

The objective of this systematic review was to analyze the effect of combined training on blood pressure in hypertensive older adults. Searches were conducted in November 2021 in the databases: National library of medicine, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences, and Scopus. Inclusion criteria were: randomized clinical trials; population aged ≥60 years and diagnosed with hypertension; combined exercise as intervention; blood pressure as one of the endpoints; published in English and/or Portuguese between 2007 and 2021 and available in full text. After the searches, 991 scientific articles were identified. From those, 9 studies were selected as they met the objective and the research criteria. Sample sizes ranged from 20-115 participants, with a mean of 48.7 ± 29.8. All studies were performed with seniors; 44.4% were conducted with a femaleonly population and 22.2% of the studies with a male-only population. Regarding the period of the intervention, it was observed that the combined training was executed from a single session up to 16 weeks, three times a week. The studies indicated that after the combined training, there were significant reductions in the values of systolic and diastolic blood pressure. Although combined training contributed significantly to reduce blood pressure values, the results of this systematic review should be interpreted with caution due to the small number of articles included and their respective methodological limitations. (AU)

Physical inactivity and high sedentary behavior are associated with hypertriglyceridemic waist in elderly / Inatividade física e elevado comportamento sedentário estão associados à cintura hipertrigliceridêmica em idosos

During aging, an increase in sedentary behaviour and a decrease in physical activity levels are observed. These factors may increase abdominal adiposity and triglyceride levels, which characterizes the hypertriglyceridemic waist (HW) phenotype, providing a high risk for cardiometabolic diseases. This study aimed to analyze the association between hypertriglyceridemic waist, physical activity level and sedentary behaviour in community-dwelling elderly. A population-based cross-sectional study was carried out, involving 316 elderlies (≥ 60 years) of both genders. The hypertriglyceridemic waist was diagnosed using high triglycerides (≥ 150 mg/dl) and increased waist circumference ≥ 88 and ≥ 102 cm values for women and men, respectively. The physical activity level and sedentary behaviour were evaluated using the IPAQ. The study included 173 women (54.7%) and 143 men (45.3%), with a mean age of 74.2 ± 9.8 years. The prevalence of HW was 27.1%, 47.7% insufficiently active and 24.1% high sedentary behaviour. The insufficiently active elderly (OR= 2.48; 95% CI: 1.31 - 4.71; p= 0.005) and with high sedentary behaviour (OR= 2.21; 95% CI: 1.04 - 4.32; p= 0.038) were associated positively with HW, indicating that elderly with insufficient physical activity levels and high sedentary behaviour showed themselves to approximately 2.5 and 2.2 times more likely to develop HW, respectively. Low physical activity level and high sedentary behaviour are associated with hypertriglyceridemic waist in community-dwelling elderly.(AU)

Durante o envelhecimento, observa-se aumento do comportamento sedentário e diminuições dos níveis de atividade física. Esses fatore podem aumentar a adiposidade abdominal e os níveis de triglicerídeos, o que caracteriza o fenótipo cintura hipertrigliceridêmica (CH), proporcionando um elevado risco para doenças cardiometabólicas. O objetivo deste estudo foi analisar a associação entre cintura hiper- trigliceridêmica, nível de atividade física e comportamento sedentário em idosos. Trata-se de um estudo epidemiológico, com delineamento transversal, de base populacional e domiciliar, realizado com 316 idosos (≥ 60 anos) de ambos os sexos. A cintura hipertrigliceridêmica foi definida a partir dos triglicérideos elevados (≥ 150 mg/dl) e circunferência da cintura alterada (≥ 88 cm para mulheres e ≥ 102 cm para homens). O nível de atividade física e o comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física (IPAQ). Participaram do estudo 173 mulheres (54,7%) e 143 homens (45,3%) com idade média de 74,2 ± 9,8 anos. A prevalência de CH foi 27,1%, 47,7% eram insuficientemente ativos e 24,1% tinham elevado comportamento sedentário. Os idosos insuficientemente ativos (OR= 2,48; IC95%:1,31 - 4,71; p= 0,005) e com elevado comportamento sedentário (OR= 2,21; IC95%:1,04 - 4,32; p= 0,038) foram positivamente associados à CH, indicando que os idosos com níveis de atividade física insuficientes e com elevado comportamento sedentário apresentaram, aproximadamente, 2,5 e 2,2 vezes mais chances de desenvolverem a CH, respectivamente. A inatividade física e o elevado comportamento sedentário estiveram associados à CH em idosos residentes em comunidade.(AU)

Body composition of women with and without dynapenia defined by different cut-off points / Composição corporal de mulheres com e sem dinapenia definida por diferentes pontos de corte

ABSTRACT Objective To compare body composition of postmenopausal women with and without dynapenia, defined by different cut-off points. Methods Body composition was assessed by electrical bioimpedance and the nutritional status by the body mass index. Dynapenia was diagnosed according to handgrip strength, using the following cut-off points: handgrip strength <16kgf and <20 kgf. Results A total of 171 women (50 to 92 years of age) participated in the investigation. The mean age of non-dynapenic and dynapenic women (handgrip strength <20kgf) was 69.4±8.2 and 74.5±8.2 years, respectively. The mean age of women with dynapenia (handgrip strength <16kgf) was 75.0±10.1 years and non-dynapenic women, 71.1±8.2 years. It was found that dynapenic women, with handgrip strength <20 and <16kgf, had an average of 2.38 and 2.47kg less muscle mass respectively, when compared to non-dynapenic women (p<0.05). However, there was no difference in muscle mass between the different dynapenic groups. Non-dynapenic women (handgrip strength ≥20kgf) had more total (3.55kg) and central fat (1.47kg) (p<0.05). Conclusion Dynapenic women, diagnosed considering both cutoff points, had less total and segmental muscle mass compared to non-dynapenic women. In addition, dynapenic women with handgrip strength <20kgf had lower total and trunk adiposity.

RESUMO Objetivo Comparar a composição corporal de mulheres na pós-menopausa com e sem dinapenia a partir de diferentes pontos de corte. Métodos A composição corporal foi avaliada por bioimpedância elétrica e o estado nutricional pelo índice de massa corporal. A dinapenia foi diagnosticada por meio da força de preensão manual, utilizando-se os seguintes pontos de corte: força de preensão manual <16kgf e <20kgf. Resultados Participaram da pesquisa 171 mulheres (50 a 92 anos). A média de idade das não dinapênicas e das dinapênicas (força de preensão manual <20 kgf) foi 69,4±8,2 e 74,5±8,2 anos, respectivamente. As mulheres com dinapenia pela força de preensão manual <16kgf apresentaram média de idade de 75,0±10,1 anos e as não dinapênicas tinham, em média, 71,1±8,2 anos. Verificou-se que as mulheres dinapênicas, com força de preensão manual <20 e <16kgf, tinham em média 2,38 e 2,47kg a menos de massa muscular quando comparadas às não dinapênicas (p<0,05). Contudo, não foi observada diferença na massa muscular entre os diferentes grupos dinapênicos. As mulheres não dinapênicas (força de preensão manual ≥20kgf) apresentaram maior gordura total (3,55kg) e central (1,47kg) (p<0,05). Conclusão As mulheres dinapênicas, diagnosticadas por ambos os pontos de corte, apresentaram menor massa muscular total e por segmento em relação às não dinapênicas. Ademais, as dinapênicas com força de preensão manual <20kgf possuíam menor adiposidade total e no tronco.

Anthropometric indicators as screening tools for sarcopenia in older adult women / Indicadores antropométricos como instrumentos de valoración para sarcopenia en mujeres ancianas

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

OBJETIVO: Investigar la asociación entre sarcopenia y diferentes indicadores antropométricos, y evaluar qué indicador discrimina mejor sarcopenia en mujeres ancianas residentes en la comunidad. MÉTODO: Fueron analizados datos de 173 mujeres ancianas (≥60 años), residentes en Lafaiete Coutinho, una pequeña ciudad en el noreste de Brasil. La sarcopenia se definió con base en el consenso europeo sobre definición y diagnóstico mediante 3 componentes: masa muscular, fuerza muscular y rendimiento. La asociación entre sarcopenia y los indicadores antropométricos (índice de masa corporal, área muscular del brazo corregida y perímetro de la pantorrilla) fue testada por medio de la técnica de regresión logística binaria. RESULTADOS: El modelo de regresión ajustado indicó que todos los indicadores antropométricos fueron inversamente asociados a la sarcopenia, siendo que el aumento en una unidad en el índice de masa corporal, área muscular del brazo corregida o perímetro de la pantorrilla disminuyó en aproximadamente un 85, un 16 y un 72%, respectivamente, la probabilidad de sarcopenia en las mujeres ancianas. CONCLUSIÓN: Los indicadores antropométricos estudiados pueden utilizarse como discriminadores de sarcopenia en una población de mujeres ancianas. El índice de masa corporal mostró una mejor sensibilidad y el perímetro de la pantorrilla, una mayor especificidad con este fin. Los resultados del estudio pueden mejorar la práctica enfermera y de otros profesionales de la salud, permitiendo la detección de.sarcopenia en mujeres ancianas a partir de indicadores antropométricos simples y de bajo costo

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.

Pacientes internados em unidade de terapia intensiva que não adotam postura antigravitacional apresentam maiores chances de óbito / Pacientes hospitalizados en unidad de cuidados intensivos que no adoptan postura antigravitacional pueden tener mayores posibilidades de fallecimiento / Patients admitted to an intensive care unit who do not adopt an antigravity posture have a higher odds of death

RESUMO Ainda há poucos marcadores de desempenho funcional com capacidade de predizer óbito em unidades de terapia intensiva (UTI). O objetivo do presente estudo foi identificar a associação entre a não adoção de postura antigravitacional e óbito em pacientes internados em uma UTI adulto. Trata-se de um estudo retrospectivo e analítico, realizado através da análise de prontuários. A associação entre a não adoção de postura antigravitacional e óbito foi testada por regressão logística múltipla ajustada por sexo, idade, gravidade da doença (mensurada pelo Acute Physiology and Chronic Health Classification System II [Apache II]), tempo de ventilação mecânica invasiva (VMI) e tempo de sedação. A odds ratio (OR) foi estimada com intervalo de confiança de 95%. Foram incluídos no estudo 92 pacientes sequenciais. Houve forte associação entre a não adoção de postura antigravitacional em UTI e óbito (ORajustada=37,7; IC=4,76-293; p=0,001). Conclui-se que pacientes que não adotaram postura antigravitacional durante o internamento em UTI apresentaram chances muito mais elevadas de mortalidade. Essa simples estratégia de classificação da capacidade funcional de pacientes críticos pode ser utilizada rotineiramente por equipes de saúde como uma variável simples e dicotômica de prognóstico de mortalidade em UTI.

RESUMEN Aún existen pocos marcadores de desempeño funcional con capacidad de predecir la muerte en Unidades de Cuidados Intensivos (UCI). El presente estudio tuvo como objetivo identificar la asociación entre la no adopción de postura antigravitacional y el óbito en pacientes hospitalizados en una UCI adulto. Se trata de un estudio retrospectivo y analítico, realizado mediante análisis de historia clínica. La asociación entre la no adopción de postura antigravitacional y el fallecimiento fue probada por regresión logística múltiple ajustada por sexo, edad, gravedad de la enfermedad (medida por la Acute Physiology And Chronic Health Classification System II [Apache II]), tiempo de ventilación mecánica invasiva (VMI) y tiempo de sedación. Se estimó la odds ratio (OR) con intervalo de confianza (IC=95%). Se incluyeron en el estudio 92 pacientes secuenciales. Se observó una fuerte asociación entre la no adopción de postura antigravitacional en UCI y el óbito (ORajustada=37,7; IC=4,76-293; p=0,001). De esta forma, se puede concluir que pacientes que no adoptaron postura antigravitacional durante la hospitalización en UCI tuvieron posibilidades mucho más elevadas de mortalidad. Esta simple estrategia de clasificación de la capacidad funcional de pacientes críticos puede ser utilizada de manera rutinaria por el equipo de salud como una variable simple y dicotómica de pronóstico de mortalidad en UCI.

ABSTRACT Until now, few functional performance markers are able to predict death in Intensive Care Units (ICUs). This study aimed to identify the association between non-adoption of antigravity posture and death in patients admitted to an adult ICU. It is a retrospective and analytical study, performed through the analysis of medical records. Association between non-adoption of antigravity posture and death was tested by multiple logistic regression adjusted for gender, age, disease severity (measured by Acute Physiology and Chronic Health Classification System II [Apache II]), time of invasive mechanical ventilation (IMV), and period of sedation. The odds ratio (OR) with confidence interval (CI=95%) was estimated. A total of 92 sequential patients were included in the study. A strong association between the non-adoption of antigravity posture in the ICU and death (ORadjusted=37.7, CI=4.76-293, p=0.001) was observed. Thus, one can conclude that patients who did not adopt an antigravity posture during ICU admission had a much higher odds of mortality. This simple strategy to classify functional capacity of critical patients can be routinely used by the team as a simple and dichotomous variable for ICU mortality prognosis.

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.

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.

Prevalence and factors associated with hypertriglyceridemic waist in the elderly: a population-based study / Prevalência e fatores associados à cintura hipertrigliceridêmica em idosos: um estudo de base populacional

Abstract 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.

Resumo Identificar a prevalência e os fatores associados à cintura hipertrigliceridêmica em idosos residentes em uma comunidade no nordeste do Brasil. Estudo populacional com delineamento transversal. Participaram do estudo 316 idosos com idade ≥ 60 anos, de ambos os sexos. Os dados foram coletados por meio de um formulário próprio, baseado no questionário usado na Pesquisa Saúde, Bem-Estar e Envelhecimento, além dos exames sanguíneos, aferição da pressão arterial e medidas antropométricas. A cintura hipertrigliceridêmica (CH) foi diagnosticada quando os níveis de triglicerídeos apresentaram valores (≥ 150 mg/dl) e a circunferência da cintura ≥ 88cm para as mulheres e 102 para os homens. Para identificar os fatores associados a CH foi utilizado a análise de regressão logística, com nível de significância 5%. A prevalência de cintura hipertrigliceridêmica foi 27,1%. O modelo de regressão logística (OR) ajustado mostrou a condição de CH associada ao sexo feminino (OR 4.19), aos idosos insuficientemente ativos (OR 2.41) e com sobrepeso (OR 4.06). Foi observada uma alta prevalência de cintura hipertrigliceridêmica em idosos residentes em comunidade, apontando o sexo feminino, a inatividade física e o sobrepeso/obesidade como fatores associados.