What is the impact of the European Consensus on the diagnosis and prevalence of sarcopenia among institutionalized elderly persons? / Qual o impacto do consenso europeu no diagnóstico e prevalência de sarcopenia em idosos institucionalizados?

Abstract Objective: To verify the impact of the European Consensus on the diagnosis and prevalence of sarcopenia among institutionalized elderly persons in Natal, Rio Grande do Norte, Brazil. Method: 219 elderly persons (≥60 years) of both genders were recruited for the study. Two criteria were initially used to calculate the prevalence of sarcopenia: criterion A, based on the European Consensus, considering only elderly persons with good physical and cognitive conditions and criterion B, considering all elderly individuals, regardless of their physical and/or cognitive condition. The association between sarcopenia and gender, age and body mass index (BMI) in the two groups was investigated using the chi-square test and the Student's t-test, with a significance level of 5%. Result: the diagnosis of sarcopenia according to Criterion A revealed a prevalence of 32% (95% CI: 22.54-43.21), whereas Criterion B identified a prevalence of 63.2% (95% CI: 56; 45-69,13). Despite the difference in the prevalence of sarcopenia using the two criteria employed (p<0.001), no differences were observed in terms of the association with gender (p=0.149, p=0.212), BMI (p<0.001, p<0.001), and age (p=0.904, p=353). Conclusion: including only elderly people with good physical and cognitive abilities to calculate sarcopenia, based on the European Consensus, underestimates the prevalence of this condition among institutionalized elderly. As elderly persons with physical or cognitive limitations are extremely typical in the population of care facilities and increased diagnostic calculation for sarcopenia did not interfere with the distribution of associated factors, it is recommended that these individuals are considered in the basis of calculation for future studies of the diagnosis and prevalence of sarcopenia. AU

Resumo Objetivo: verificar o impacto do consenso europeu no diagnóstico e prevalência de sarcopenia em idosos institucionalizados em Natal, RN, Brasil. Método: 219 idosos (≥60 anos) de ambos os sexos foram recrutados para o estudo. Inicialmente, foram comparados dois critérios para cálculo de prevalência da sarcopenia: critério A, segundo o consenso europeu, considerando apenas idosos com boas condições físicas e cognitivas e critério B, considerando todos idosos, independente da sua condição física e/ou cognitiva. Na sequência, foi investigada a associação da sarcopenia com sexo, idade e Índice de Massa Corporal (IMC) nos dois critérios diagnósticos, através do teste do qui-quadrado ou teste t deStudent, sendo considerado nível de significância de 5%. Resultados :O diagnóstico de sarcopenia segundo o Critério A apresentou uma prevalência de sarcopenia de 32% (IC95%: 22,54-43,21), enquanto o Critério B apresentou uma prevalência de 63,2% (IC95%: 56,45-69,13). Apesar da diferença encontrada na prevalência de sarcopenia entre os dois critérios utilizados (p<0,001), não foram observadas diferenças com relação à associação com sexo (p=0,149;p=0,212), IMC (p<0,001; p<0,001) e idade (p=0,904;p=0,353). Conclusão :Incluir apenas idosos com boa capacidade física e cognitiva para cálculo de sarcopenia, conforme estipulado pelo Consenso Europeu, subestima a prevalência de sarcopenia em idosos institucionalizados. Considerando que idosos com limitações físicas ou cognitivas são extremamente representativos para a população de idosos institucionalizados e que o acréscimo deles no cálculo diagnóstico para sarcopenia não interferiu na distribuição dos seus fatores associados, recomenda-se considerá-los na base de cálculo para estudos futuros de diagnóstico e prevalência de sarcopenia. AU

Estimating weight in elderly residents in nursing homes: which equation to use? / Estimativa de peso em idosos institucionalizados: qual equação utilizar?

INTRODUCTION: When it is impossible to measure weight in the elderly, estimation methods can be employed. However, such methods are not always applicable and can lead to estimation errors that compromise both the clinical practice and the results in epidemiological studies. OBJECTIVE: To compare and validate weight estimation methods in the elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil. METHODS: The equations were evaluated qualitatively, by the reproducibility of the measurements that comprised them, and quantitatively, by the mean difference between the measured and the estimated weights, using Student's t -test for paired samples or ANOVA, the coefficient of determination (R²), root mean square error (RMSE), intra-class correlation coefficient (ICC) and graphical analysis of residuals. The significance value adopted was of p < 0.05. It was considered applicable when the equation presented R² > 0.7; lowest RMSE among the evaluated equations; ICC > 0.7; and respective 95% confidence interval with less distance between the upper and lower limits. RESULTS: We evaluated 315 elderly from 10 nursing homes in Natal. The mean body weight was higher in the younger elderly and those without mobility restriction. The qualitative analysis showed the equation 5 as having the best reproducibility, since it does not use skinfold measurements. The quantitative analysis revealed the equation 5 as the one with the best applicability across the studied population and in the different genders, age groups (60 - 69 years, 70 - 79 years, and 80 years or more), and mobility restriction conditions. CONCLUSION: The equation 5 was applicable for estimating weight in the evaluated population and in the different strata analyzed.

Estimativa de peso em idosos institucionalizados: qual equação utilizar? / Estimating weight in elderly residents in nursing homes: which equation to use?

RESUMO: Introdução: Na impossibilidade de mensuração do peso em idosos, métodos de estimativa podem ser empregados. Entretanto, tais métodos nem sempre são aplicáveis, podendo levar a erros de estimativa que comprometem tanto a prática clínica quanto resultados em estudos epidemiológicos. Objetivo: Comparar e validar métodos de estimativa de peso em idosos residentes em instituições de longa permanência de Natal, Rio Grande do Norte. Métodos: Avaliaram-se as equações qualitativamente pela reprodutibilidade das medidas que as compunham e, quantitativamente, pela diferença média entre o peso mensurado e os estimados, e utilizado o teste t de Student para amostras pareadas ou ANOVA, coeficiente de determinação (R²), raiz do erro quadrático médio (REQM), coeficiente de correlação intraclasse (CCI) e análise gráfica de resíduos. Adotou-se como valor de significância p < 0,05. Considerou-se aplicável quando a equação apresentava R² > 0,7; menor REQM dentre as equações avaliadas; CCI > 0,7; e respectivo intervalo de confiança 95% com menor distância entre os limites inferior e superior. Resultados: Avaliaram-se 315 idosos de 10 instituições de longa permanência de Natal. O peso corporal médio foi maior nos idosos mais jovens e sem restrição de mobilidade. A análise qualitativa mostrou a equação 5 como a de melhor reprodutilidade, uma vez que não utiliza medidas de dobras cutâneas. A análise quantitativa revelou a equação 5 como a de melhor aplicabilidade em toda a população avaliada e nos diferentes sexos, faixas etárias (60 a 69 anos, 70 a 79 anos e 80 anos ou mais) e condição de restrição de mobilidade. Conclusão: A equação 5 foi aplicável para a estimativa de peso na população avaliada e nos diferentes estratos analisados.

ABSTRACT: Introduction: When it is impossible to measure weight in the elderly, estimation methods can be employed. However, such methods are not always applicable and can lead to estimation errors that compromise both the clinical practice and the results in epidemiological studies. Objective: To compare and validate weight estimation methods in the elderly living in nursing homes in Natal, Rio Grande do Norte, Brazil. Methods: The equations were evaluated qualitatively, by the reproducibility of the measurements that comprised them, and quantitatively, by the mean difference between the measured and the estimated weights, using Student's t -test for paired samples or ANOVA, the coefficient of determination (R²), root mean square error (RMSE), intra-class correlation coefficient (ICC) and graphical analysis of residuals. The significance value adopted was of p < 0.05. It was considered applicable when the equation presented R² > 0.7; lowest RMSE among the evaluated equations; ICC > 0.7; and respective 95% confidence interval with less distance between the upper and lower limits. Results: We evaluated 315 elderly from 10 nursing homes in Natal. The mean body weight was higher in the younger elderly and those without mobility restriction. The qualitative analysis showed the equation 5 as having the best reproducibility, since it does not use skinfold measurements. The quantitative analysis revealed the equation 5 as the one with the best applicability across the studied population and in the different genders, age groups (60 - 69 years, 70 - 79 years, and 80 years or more), and mobility restriction conditions. Conclusion: The equation 5 was applicable for estimating weight in the evaluated population and in the different strata analyzed.

The construction of ergonomic demands: application on artisan fishing using jangada fishing rafts in the beach of Ponta Negra.

The present article seeks the process of construction of ergonomics demand referring to the artisan fishing activityfound in Ponta Negra beach located in the city of Natal, Brazil. The instruction/construction of demands correspond to the first stage of Work Ergonomic Analysis and allows the understanding of real issues existent in a work situation, rank them and route the providences. The demand presented on this study, features itself as a induced demand, process which some potential demands or hypothetical demands are taken to an organization, after a preview analysis of the work aimed by the study, resulting from a theoretical research (state of the art) and/or from analysis of a reference situation (state of practice), where demands hypothesis are taken in consideration about the pretended work. The demands construction process using interactional methods and techniques, observation methods and techniques and bibliographic research, researches in state of reference or document. This article demonstrates the efficiency of the methodological choice to construct real ergonomic demands and highlights the importance of social construction on that process, which main goal is to refer the ergonomic actions that allow the improvement of work and life conditions for the fishers and sustainability to Jangadeira activity.