Sex effects on the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults: data from the SARCOS study

ABSTRACT Objective: The objective was to evaluate the association between sarcopenia (EWGSOP) and osteoporosis in older adults. Subjects and methods: This is a cross sectional analysis of a baseline evaluation of the SARCopenia and OSteoporosis in Older Adults with Cardiovascular Diseases Study (SARCOS). Three hundred and thirty-two subjects over 65 years of age were evaluated. Sarcopenia was determined by EWGSOP flowchart and Osteoporosis was established by WHO's criteria. Physical function, comorbidities and medications were evaluated. Results: Women were older (79.8 ± 7.2 years) than men (78.21 ± 6.7 years) (p = 0.042). Osteoporosis occurred in 24.8% of men, and in 42.7% of women (p < 0.001); sarcopenia occurred in 25.5% of men and in 17.7%, of women (p = 0.103). Osteoporosis was diagnosed in 68% of sarcopenic women, however only 20.7% (p = 0.009) of women with osteoporosis had sarcopenia; in older men, 44.7% of individuals with sarcopenia presented osteoporosis and 42.9% (p = 0.013) of men with osteoporosis showed sarcopenia. In an adjusted logistic regression analyses for sarcopenia, osteoporosis presented a statistically significant association with sarcopenia in men [OR: 2.930 (95% CI: 1.044-8.237; p = 0.041)] but not in women [OR: 2.081 (0.787-5.5; p = 0.142)]; in the adjusted logistic regression analyses for osteoporosis, a statistically significant association occurred in men [OR: 2.984 (95% CI: 1.144-7.809; p = 0.025)], but not in women [OR: 2.093 (0.962-3.714; p = 0.137)]. Conclusion: According to sex, there are significant differences in the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults. It is strong and significant in males; in females, despite showing a positive trend, it was not statistically significant.

Fragilidade é um preditor independente de morte precoce em idosos ambulatoriais com doenças cardiovasculares no Estudo SARCOS / Frailty is an independen t predictor of early death in elderly outpatients with cardiovascular disease in the SARCOS Study

Introdução: A fragilidade caracteriza-se pela perda da capacidade biológica e física de responder adequadamente ao estresse orgânico devido aos danos a diversos sistemas associados ao processo de envelhecimento. Entre os indivíduos com doenças cardiovasculares, a frequência da fragilidade é três vezes maior. Métodos: SARCOS é um estudo epidemiológico de coorte para avaliar a síndrome de vulnerabilidade com hospitalização e mortalidade em idosos ambulatoriais com doença cardiovascular (DCV). A fragilidade foi diagnosticada na presença de três ou mais dos seguintes critérios: perda de peso > 5%, velocidade de marcha reduzida, fraqueza muscular pela força de preensão, exaustão e perda de energia (levantar e sentar da cadeira cinco vezes). Resultados: Dos 169 pacientes avaliados, a fragilidade ocorreu em 19,5% (n=33). A média de idade foi de 78,3 ± 7,1 anos. A taxa mortalidade aos seis meses foi de 3% (n=5), sendo que 80% (n=4) eram frágeis e 20% (n=1) pré-frágeis (p=0,007). Na análise de regressão logística, a fragilidade mostrou ser um forte preditor de morte aos seis meses, com aumento de risco de 18 vezes quando comparado aos fortes (p=0,010), enquanto que entre as DCVs, a insuficiência cardíaca apresentou aumento de risco de quatro vezes (p=0,061). No modelo de interação entre a fragilidade e as DCVs, não houve diferença significativa da fragilidade em relação ao risco de morte. Conclusão: A fragilidade é um importante fator de risco de morte precoce em idosos ambulatoriais, independente e superior às doenças cardiovasculares crônicas mais frequentes que acometem essa população. A síndrome da fragilidade não apresenta sinergia com doenças cardiovasculares crônicas em relação ao risco de morte

Introduction: Frailty is characterized by the loss of the biological and physical capacity to respond adequately to organic stress as a result of damage to various systems associated with aging. The frequency of frailty is three times higher among individuals with cardiovascular disease. Methods: SARCOS is an epidemiological cohort study to evaluate vulnerability syndrome with hospitalization and mortality in elderly patients with cardiovascular disease (CVD). Frailty was diagnosed when three or more of the following criteria were present: Weight loss > 5%, slow walking speed, muscle weakness by the hand-grip test, exhaustion, and loss of energy (by the five times sit-to-stand test). Results: Of the 169 patients evaluated, frailty was present in 19.5%(n = 33). The mean age was 78.3 ± 7.1 years. The mortality rate at six months was 3% (n = 5), with 80% (n = 4) being frail and 20% (n = 1) pre-frail (p = 0.007). In the logistic regression analysis, frailty was shown to be a strong predictor of death at six months, with an 18-fold increase in risk when compared to strong individuals (p = 0.010), whereas among those with CVD, the heart failure presented a 4-fold increase in risk (p = 0.061). In the interaction model between frailty and CVD, there were no significant differences in frailty in relation to the risk of death. Conclusion: Frailty is an important risk factor for early death among outpatients, independent of, and higher than the most frequent chronic cardiovascular diseases that affect this population. Frailty syndrome was not correlated with chronic cardiovascular diseases, in relation to the risk of death

Sex effects on the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults: data from the SARCOS study.

OBJECTIVE: The objective was to evaluate the association between sarcopenia (EWGSOP) and osteoporosis in older adults. SUBJECTS AND METHODS: This is a cross sectional analysis of a baseline evaluation of the SARCopenia and OSteoporosis in Older Adults with Cardiovascular Diseases Study (SARCOS). Three hundred and thirty-two subjects over 65 years of age were evaluated. Sarcopenia was determined by EWGSOP flowchart and Osteoporosis was established by WHO's criteria. Physical function, comorbidities and medications were evaluated. RESULTS: Women were older (79.8 ± 7.2 years) than men (78.21 ± 6.7 years) (p = 0.042). Osteoporosis occurred in 24.8% of men, and in 42.7% of women (p < 0.001); sarcopenia occurred in 25.5% of men and in 17.7%, of women (p = 0.103). Osteoporosis was diagnosed in 68% of sarcopenic women, however only 20.7% (p = 0.009) of women with osteoporosis had sarcopenia; in older men, 44.7% of individuals with sarcopenia presented osteoporosis and 42.9% (p = 0.013) of men with osteoporosis showed sarcopenia. In an adjusted logistic regression analyses for sarcopenia, osteoporosis presented a statistically significant association with sarcopenia in men [OR: 2.930 (95% CI: 1.044-8.237; p = 0.041)] but not in women [OR: 2.081 (0.787-5.5; p = 0.142)]; in the adjusted logistic regression analyses for osteoporosis, a statistically significant association occurred in men [OR: 2.984 (95% CI: 1.144-7.809; p = 0.025)], but not in women [OR: 2.093 (0.962-3.714; p = 0.137)]. CONCLUSION: According to sex, there are significant differences in the association between sarcopenia EWGSOP and osteoporosis in outpatient older adults. It is strong and significant in males; in females, despite showing a positive trend, it was not statistically significant.

Correlação entre estado nutricional e força de preensão palmar em idosos / Correlation between nutritional status and hand grip strength in elderly

No envelhecimento ocorrem mudanças corpóreas, dentre as quais a diminuição de massa magra com prejuízo na força muscular, afetando a capacidade funcional. Atualmente, o teste de Força de Preensão Palmar (FPP) está sendo utilizado para avaliar a força muscular global como auxiliar na avaliação nutricional. OBJETIVO: Verificar a correlação entre o estado nutricional e a FPP em idosos. MÉTODOS: Estudo transversal realizado com idosos atendidos em ambulatórios de uma universidade pública federal. Para a classificação do estado nutricional, utilizam-se: índice de massa corpórea (IMC), avaliação nutricional por meio da Mini-Avaliação Nutricional (MAN), circunferência da panturrilha (CP) e FPP realizada com auxílio de um dinamômetro manual hidráulico. Utilizaram-se como referência para a FPP e IMC os pontos de cortes divididos por gênero (projeto SABE/OPAS). RESULTADOS: Amostra constituída (n=42) na sua maioria por mulheres (66,7%), apresentando em média 26,82 pontos na MAN e pelo IMC a maioria dos idosos eram eutróficos - 46,4% mulheres e 57,1% homens. Homens e mulheres obtiveram média superior a 31 cm de circunferência da panturrilha (CP). A média de força para homens foi superior ao valor obtido pelas mulheres. Não houve diferença estatisticamente significante entre o estado nutricional classificado pelo IMC e a FPP para homens e mulheres; houve correlação estatisticamente significante (p 0,008) entre o estado nutricional classificado pela MAN e a força de preensão palmar na amostra total. CONCLUSÕES: Dentre os métodos para avaliar o estado nutricional, apenas a MAN correlacionou-se positivamente com a FPP, que é uma medida associada à funcionalidade em idosos.

In the aging process, body changes occur, such as reduction of lean mass with impaired muscle strength, affecting the functional capacity. Currently, the Hand Grip Strength Test (HGST) is being used to evaluate the overall muscle strength as an aid in nutritional assessment. OBJECTIVE: To investigate the correlation between the HGST and nutritional status in the elderly. METHODS: Cross sectional study on elderly people attending outpatient of a Federal Public University. To evaluate the nutritional status, were used: body mass index (BMI), nutritional evaluation by Mini Nutritional Assessment (MNA), calf circumference and HGST performed with the aid of a hydraulic hand dynamometer. It was used as reference for the GSTP and the BMI, cutoff points divided by gender (SABE / OPAS Project). RESULTS: The sample was mostly formed (n = 42) by women (66.7%), with an average of 26.82 points in the MNA and BMI, most seniors were eutrophic - 46.4% women and 57.1% men. Men and women were averaged over 31 cm of calf circumference. The average strength for men was higher than women. There was no statistically significant difference between nutritional status classified by BMI and HGST for men and women, there was a statistically significant correlation (p 0.008) between the nutritional status classified by MNA and hand grip strength in the total sample. CONCLUSIONS: Among the methods to assess nutritional status, only MNA correlated positively with the HGST, which is a measure associated with the functionality in the elderly.