Fatores sociodemográficos e clínicos associados à força de preensão manual de idosos condutores de veículos / Sociodemographic and clinical factors associated with handgrip strength in elderly automobile drivers / Factores sociodemográficos y clínicos asociados a la fuerza de prensión de la mano en conductores de vehículos de ancianos

Objetivo: investigar a associação entre força de preensão manual e características sociodemográficas e clínicas de idosos condutores de veículos automotores. Método: estudo transversal, realizado em clínicas de medicina de tráfego na cidade de Curitiba/Paraná, com 421 idosos (≥ 60 anos). Realizou-se análise estatística pelo modelo de Regressão Logística e Teste de Wald, considerando intervalo de confiança de 95% e valores de p <0,05 como significativos. Resultados: oitenta e quatro (20%) idosos apresentaram força de preensão manual reduzida. A força de preensão manual reduzida foi associada à faixa etária (p=0,001) e à hospitalização no último ano (p=0,002). Conclusão: houve associação significativa entre a força de preensão manual de idosos motoristas e as variáveis idade e hospitalização no último ano. Dessa forma, torna-se essencial a inclusão de avaliações específicas, centradas nas variáveis sociodemográficas e clínicas próprias da pessoa idosa, durante o exame de aptidão para dirigir veículos automotores.(AU)

Objective: to investigate the association between handgrip strength and sociodemographic and clinical characteristics of elderly automobile drivers. Method: cross-sectional study, carried out in traffic medicine clinics in the city of Curitiba/Paraná, with 421 elderly people (≥ 60 years old). Statistical analysis was performed using the Logistic Regression model and the Wald Test, considering a 95% confidence interval and p values <0.05 as significant. Results: eighty-four (20%) seniors had reduced handgrip strength. Reduced handgrip strength was associated with age group (p=0.001) and hospitalization in the last year (p=0.002). Conclusion: there was a significant association between the handgrip strength of elderly drivers and the variables age and hospitalization in the last year. Thus, it is essential to include specific assessments, centered on sociodemographic and clinical variables specific to the elderly person, during the aptitude test to drive automobiles.(AU)

Objetivo: investigar la asociación entre la fuerza de prensión de la mano y las características sociodemográficas y clínicas de los ancianos conductores de vehículos automotores. Método: estudio transversal, realizado en clínicas de medicina de tránsito de la ciudad de Curitiba/Paraná, con 421 ancianos (≥ 60 años). El análisis estadístico fue realizado por el modelo de Regresión Logística y Test de Wald, considerando intervalo de confianza de 95% y valores de p <0,05 como significativos. Resultados: 84 (20%) sujetos ancianos presentaron reducción de la fuerza de prensión de la mano. La reducción de la fuerza de prensión de la mano se asoció al grupo de edad (p=0,001) y a la hospitalización en el último año (p=0,002). Conclusión: hubo una asociación significativa entre la fuerza de prensión de la mano de los conductores ancianos y las variables edad y hospitalización en el último año. Así pues, es esencial incluir evaluaciones específicas, centradas en las variables sociodemográficas y clínicas de los ancianos, durante el examen de aptitud para conducir vehículos automotores.(AU)

Calidad de vida, nivel de actividad física y pruebas funcionales en personas adultas y mayores laboralmente activas / Quality of life, level of physical activity and functional tests in actively working adults and older people

BACKGROUND: The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. AIM: To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. MATERIAL AND METHODS: Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. RESULTS: Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = −0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = −0.197; P = 0.021; older people rs = - 0.212; p = 0.02). CONCLUSIONS: There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores / Handgrip strength as a predictor of adverse health outcomes

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

Relação entre força de preensão manual, funcionalidade e fragilidade física em pessoas idosas: revisão integrativa / Relación entre fuerza de agarre manual, funcionalidad y fragilidad física en ancianos: una revisión integradora / Relationship between handgrip strength, functionality, and physical frailty in elderly people: an integrative review

RESUMO Objetivo: analisar as publicações científicas sobre a relação entre força de preensão manual, funcionalidade e fragilidade física em pessoas idosas. Método: revisão integrativa realizada nas bases de dados PubMed, CINAHL, Web of Science e Portal BVS, no período amostral de janeiro de 2010 a novembro de 2021. Empregou-se o fluxograma do Preferred Reporting Items for Systematic Reviews and Meta-analyses para apresentar a seleção dos estudos, e o nível de evidência foi avaliado a partir do Oxford Centre for Evidence-Based Medicine e as referências gerenciadas no EndNote Web. Resultados: a busca inicial resultou em 211 estudos após a aplicação dos critérios de elegibilidade, sendo que 7 estudos constituíram a revisão integrativa. A força de preensão manual se revelou um importante indicador de força muscular e crucial para a funcionalidade das pessoas idosas. Quando associada a determinadas ocorrências clínicas, a força de preensão manual colabora para a redução da funcionalidade e dependência na realização das atividades de vida diária em idosos, com maior prejuízo entre aqueles com 75 anos ou mais, de forma mais significativa entre as mulheres. Conclusão: a relação entre a força de preensão reduzida e a diminuição da funcionalidade determina a condição de fragilidade física em pessoas idosas. Isso reforça a importância do investimento dos profissionais de Enfermagem em intervenções que viabilizem a manutenção da força muscular e da funcionalidade e a reversão da fragilidade física nesse segmento populacional.

RESUMEN Objetivo: analizar las publicaciones científicas sobre la relación entre la fuerza de agarre manual, la funcionalidad y la fragilidad física en ancianos. Método: revisión integradora realizada en las bases de datos PubMed, CINAHL, Web of Science y Portal BVS, desde enero de 2010 hasta noviembre de 2021. Se utilizó el diagrama de flujo de los Preferred Reporting Items for Systematic Reviews and Meta-analyses para presentar la selección de estudios, se evaluó el nivel de evidencia del Oxford Centre for Evidence-Based Medicine y se gestionaron las referencias en EndNote Web. Resultados: la búsqueda inicial dio lugar a 211 estudios, tras aplicar los criterios de elegibilidad, siete estudios constituyeron la revisión integradora. La fuerza de agarre de la mano resultó ser un indicador importante de la fuerza muscular y crucial para la funcionalidad de los ancianos. Cuando se asocia a determinadas circunstancias clínicas, la fuerza de la presión manual contribuye a la reducción de la funcionalidad y la dependencia en la realización de las actividades de la vida diaria en los individuos, con mayor prejuicio entre los que tienen 75 años o más y de forma más significativa entre las mujeres. Conclusión: la relación entre la fuerza de agarre reducida y la disminución de la funcionalidad determina la condición de fragilidad física en los ancianos. Esto refuerza la importancia de que los profesionales de Enfermería inviertan en intervenciones que permitan mantener la fuerza y la funcionalidad muscular y revertir la fragilidad física en este segmento de la población.

ABSTRACT Objective: to analyze scientific publications on the relationship between handgrip strength, functionality, and physical frailty in the elderly. Method: integrative review carried out in PubMed, CINAHL, Web of Science and VHL Portal databases, in the sample period from January 2010 to November 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses flowchart was used to present the selection of studies, and the level of evidence was assessed from the Oxford Center for Evidence-Based Medicine and references managed in EndNote Web. Results: the initial search resulted in 211 studies after applying the eligibility criteria, with 7 studies constituting the integrative review. Handgrip strength proved to be an important indicator of muscle strength and crucial for the functionality of elderly people. When associated with certain clinical occurrences, handgrip strength contributes to the reduction of functionality and dependence in carrying out activities of daily living in the elderly, with greater impairment among those aged 75 years or older, more significantly among women. Conclusion: the relationship between reduced grip strength and decreased functionality determines the condition of physical frailty in elderly people. This reinforces the importance of investment by Nursing professionals in interventions that enable the maintenance of muscle strength and functionality and the reversal of physical frailty in this population segment.

Correlação entre funcionalidade e força de preensão manual e a condição de fragilidade física em idosos da atenção primária à saúde / Correlation between functionality and handgrip strength and the condition of physical frailty in elderly people in primary health care

Resumo: Trata-se de estudo quantitativo transversal cujo objetivo foi analisar a correlação entre funcionalidade e força de preensão manual e a condição de fragilidade física em idosos da atenção primária à saúde. Participaram 389 idosos (=60 anos) de ambos os sexos, cadastrados em uma Unidade Básica de Saúde de Curitiba, Paraná. A coleta de dados ocorreu de janeiro a novembro de 2019, foi precedida pela aplicação do miniexame do estado mental, seguida dos questionários sociodemográfico e clínico, escala da medida de independência funcional (MIF) e avaliação da fragilidade física. Os dados foram organizados no programa Microsoft Excel® 2007 e analisados no software R CORE TEAM, mediante estatística descritiva, análises bivariadas (p<0,05), testes de Kruskal-Wallis, Dunn, qui-quadrado e Spearman. Dos 389 idosos, 34 (8,7%) eram frágeis, 186 (47,8%) pré-frágeis, 169 (43,5%) não frágeis, 255 (65,6%) do sexo feminino e 186 (47,8%) na faixa etária entre 60 e 69 anos. A FPM reduzida foi identificada em 82 (21%) idosos e distribuída entre 27 (79,5%) frágeis e 55 (29,5%) pré-frágeis. Houve correlação significativa entre funcionalidade e força de preensão manual segundo à condição de fragilidade física (Pˆ= 0,330; p=<0,001). A média da FPM foi maior no grupo de idosos não frágeis (28,9 Kgf), comparada aos pré-frágeis (24,6 Kgf) e frágeis (17,1 Kgf). A pontuação média da funcionalidade (MIF) foi maior no grupo de idosos não frágeis (122,1 pontos) em relação aos pré-frágeis (120,6pontos) e frágeis (114,2 pontos). Quanto à tarefa da MIF "controle de urina", observou-se elevada frequência idosos frágeis completamente dependentes (n=9; 26,4%) e pré-frágeis moderadamente dependentes (n=52; 27,9%). Para a tarefa "interação social" observou-se expressiva frequência de idosos frágeis moderadamente dependentes(n=12; 35,3%). Para a tarefa "resolução de problemas" evidenciou-se a mesma frequência (n=7; 20,6%) de idosos frágeis completamente dependentes e moderadamente dependentes. Na avaliação da tarefa "memória" destacaram-se os pré-frágeis moderadamente dependentes (n=26; 14%). A correlação entre funcionalidade (MIF) e FPM se mostrou fraca, positiva e significativa entre os idosos da amostra investigada (Pˆ= 0,330; p=<0,001), entre os não frágeis (Pˆ= 0,252;p=<0,001) e entre os pré-frágeis (Pˆ= 0,236; p=0,001). O desempenho nas tarefas "controle de urina" e "subir e descer escadas" correlacionou-se significativamente à FPM (p=<0,005) entre os idosos pré-frágeis. Destacam-se, com maior coeficiente de correlação com a FPM, as tarefas "controle de urina" para os idosos não frágeis (Pˆ=0,309) e "subir e descer escadas" para os pré-frágeis (Pˆ=0,222). Já a tarefa "resolução de problemas" correlacionou-se à FPM entre os idosos pré-frágeis (p=<0,004) e frágeis (p=<0,017), sendo entre esses o maior coeficiente de correlação (Pˆ= 0,408). Verifica-se ainda a correlação entre a tarefa "expressão verbal e não verbal" e a FPM para o grupo de idosos frágeis (p=<0,025; Pˆ= 0,383). Conclui-se que houve correlação positiva entre funcionalidade e FPM entre os idosos não frágeis e pré-frágeis, indicando que quanto maior a FPM, melhor é o desempenho funcional. Destacam-se resultados expressivos para a prática clínica de enfermagem gerontológica, que podem subsidiar estratégias preventivas voltadas à manutenção da FPM e da funcionalidade, principalmente entre os idosos não frágeis e pré-frágeis.

Abstract: This is a cross-sectional quantitative study whose objective was to analyze the correlation between functionality and handgrip strength and the condition of physical frailty in elderly people in primary health care. Participants were 389 elderly people (=60 years) of both sexes, registered at a Basic Health Unit in Curitiba, Paraná. Data collection took place from January to November 2019, was preceded by the application of the mini-mental state exam, followed by sociodemographic and clinical questionnaires, functional independence measure scale (FIM), and assessment of physical frailty. Data were organized in Microsoft Excel® 2007 program and analyzed in R CORE TEAM software, using descriptive statistics, bivariate analyzes (p<0.05), Kruskal-Wallis, Dunn, chi-square, and Spearman tests. Of the 389 elderly, 34 (8.7%) were frail, 186 (47.8%) were pre-frail, 169 (43.5%) were non-frail, 255 (65.6%) were female and 186 (47.8%) in the age group between 60 and 69 years. Reduced HGS was identified in 82 (21%) elderly and distributed among 27 (79.5%) frail and 55 (29.5%) pre-frail. There was a significant correlation between functionality and handgrip strength according to the condition of physical frailty (Pˆ=0.330; p=<0.001). The average HGS was higher in the group of non-frail elderly (28.9 Kgf), compared to pre-frail (24.6 Kgf) and frail (17.1 Kgf). The mean functionality score (MIF) was higher in the group of non-frail elderly (122.1 points) compared to pre-frail (120.6 points) and frail (114.2 points). As for the FIM task "urine control", a high frequency of completely dependent frail elderly (n=9; 26.4%) and moderately dependent pre-frail (n=52; 27.9%) was observed. For the "social interaction" task, there was a significant frequency of moderately dependent frail elderly was observed (n=12; 35.3%). For the "problem solving" task, the same frequency (n=7; 20.6%) of completely dependent and moderately dependent frail elderly individuals was observed. In the evaluation of the "memory" task, the moderately dependent pre-frail stood out (n=26; 14%). The correlation between functionality (MIF) and HGS was weak, positive, and significant among the elderly in the investigated sample (Pˆ= 0.330; p=<0.001), among the nonfrail (Pˆ=0.252; p=<0.001) and among the elderly. pre-fragile (Pˆ= 0.236; p=0.001). The performance in the tasks "urine control" and "going up and down stairs" was significantly correlated with HGS (p=<0.005) among the pre-frail elderly. The tasks "urine control" for the non-frail elderly (Pˆ=0.309) and "going up and down stairs" for the pre-frail stand out, with the highest correlation coefficient with HGS (Pˆ=0.222). The "problem solving" task was correlated with HGS among pre-frail (p=<0.004) and frail (p=<0.017) elderly, with the highest correlation coefficient (Pˆ=0.408) among these. There is also a correlation between the task "verbal and non-verbal expression" and HGS for the frail elderly group (p=<0.025; Pˆ=0.383). It was concluded that there was a positive correlation between functionality and HGS among the non-frail and pre-frail elderly, indicating that the higher the HGS, the better the functional performance. Significant results for the clinical practice of gerontological nursing stand out, which can support preventive strategies aimed at maintaining HGS and functionality, especially among non-frail and pre-frail elderly people.

Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study / Prevalência e fatores de risco para obesidade abdominal dinapênica em idosos residentes na comunidade: um estudo transversal

Abstract This article aims to identify the prevalence of and factors associated with dynapenic abdominal obesity (DAO) in older adults in a city in the northern region of Brazil. A cross-sectional study was conducted with 382 community-dwelling older adults in Macapa, Amapa, Brazil. Socioeconomic, clinical, and health information were collected using a structured form. DAO was defined as a combination of dynapenia (handgrip strength of < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). Descriptive and inferential analyses were performed using chi-squared tests, Student's t-tests, and a Poisson regression. The prevalence of DAO was 10.73%. In the preliminary bivariate analysis, the variables of age range, marital status, number of diseases, functional disability for basic and instrumental activities of daily living, gait speed, and level of physical activity met the established criterion. The final model indicated that only gait speed was a predictor of DAO in older adults. DAO affects nearly 11% of community-dwelling older adults from northern Brazil; gait speed was a predictor of DAO and could be a useful tool for managing and monitoring this population's health.

Resumo O objetivo deste artigo é identificar a prevalência e os fatores associados à obesidade abdominal dinapênica (OAD) em idosos de uma cidade da região Norte do Brasil. Estudo transversal realizado com 382 idosos comunitários residentes em Macapá, Amapá, Brasil. As informações socioeconômicas, clínicas e de saúde foram coletadas por meio de um formulário estruturado. A OAD foi definida pela combinação de dinapenia (força de preensão manual < 26 kgf para homens e < 16 kgf para mulheres) e obesidade abdominal (circunferência abdominal > 102 cm para homens e > 88 cm para mulheres). As análises descritivas e inferenciais foram realizadas utilizando os testes qui-quadrado, t de Student e regressão de Poisson. A prevalência de OAD foi de 10,73%. Na análise bivariada preliminar, as variáveis faixa etária, estado conjugal, número de doenças, incapacidade funcional para atividades básicas e instrumentais de vida diária, velocidade da marcha e nível de atividade física atenderam ao critério estabelecido. O modelo final indicou que apenas a velocidade da marcha foi um preditor para a OAD em idosos. A OAD afeta quase 11% dos idosos residentes nessa comunidade do Norte do Brasil; e a velocidade de marcha é um preditor que pode ser uma ferramenta útil para gerenciar e monitorar a saúde desta população.

Grip strength is a strong predictor of survival in nonagenarians and centenarians / Força de preensão palmar e sobrevivência em nonagenários e centenários

Objectives: To understand the importance of hand grip strength (HGS) as a survival predictor in nonagenarians and centenarians. Methods: Longitudinal, observational and analytical study, using HGS measurements obtained during a first evaluation performed in 2016. Participants were nonagenarians and centenarians, randomly selected in various neighborhoods of Porto Alegre (RS) and evaluated in their homes. The time elapsed between the first evaluation and the date of death or last contact (for survivors) was used to calculate the hazard ratio (HR) using survival analysis on simple and adjusted Cox regression models. Results: The sample comprised 212 participants (155 women), of whom 83 (39%) died during follow-up (until August 30, 2019). Using the lowest quartile (25%) for HGS, participants with < 10 kgf for women and 17 kgf for men were considered to have poor HGS performance. In the simple regression model, participants with lower HGS presented a HR of 2.75 (1.76­4.30, p < 0.001) for death. Also in the simple model, participants aged between 90 and 94 years old presented an HR of 0.37 (0.16­0.85, p = 0.019) compared to those aged 100 or older. In the adjusted model, age lost its significance in the presence of HGS. The following were significant predictors in both simple and adjusted models: cognitive performance, calf circumference, ability to participate in social activities, shop, and prepare meals alone, performance in the Timed Up and Go test, and ease to perform activities requiring upper limb strength. Conclusions: HGS was an important independent and modifiable predictor of survival among nonagenarians and centenarians.

Objetivos: Compreender a importância da força de preensão palmar (FPP) como preditor em nonagenários e centenários. Metodologia: Estudo, longitudinal, observacional e analítico, utilizando os resultados da FPP medidos na primeira avaliação realizada em 2016. Os participantes eram nonagenários e centenários, selecionados aleatoriamente em vários bairros de Porto Alegre (RS) e avaliados em suas residências. Os participantes com 10 kgf para mulheres e 17 kgf para homens foram considerados com menor desempenho da FPP. O tempo entre a primeira avaliação e a data do óbito ou último contato (entre sobreviventes) foi calculado para avaliar a Razão de Dano (RD) usando análise de sobrevida por modelos simples e ajustados da Regressão de Cox. Resultados: A amostra foi composta por 212 participantes, 155 mulheres, 83 (39%) faleceram durante acompanhamento (até 30 de agosto de 2019). Na regressão simples, os participantes com menor desempenho na FPP apresentaram RD de 2,75 (1,76 ­ 4,30, p < 0,001). No modelo simples, participantes com idade entre 90 e 94 anos, apresentaram RD de 0,37 (0,16 ­ 0,85, p = 0,019) em relação aos centenários. No modelo ajustado, a idade perdeu sua significância na presença da FPP. Foram preditores significativos nos modelos simples e ajustados: desempenho cognitivo, circunferência da panturrilha, ser capaz de participar de atividades sociais e fazer compras e preparar refeições sozinho, desempenho no teste Timed Up and Go, e a facilidade para realizar atividades que exijam membros superiores. Conclusões: Concluímos que a FPP foi um importante preditor independente de sobrevida entre nonagenários e centenários, o que poderia ser melhorado por uma intervenção clínica.

Insuficiência familiar e a condição e os marcadores de fragilidade física de idosos em assistência ambulatorial / Insuficiencia familiar y la condición y los marcadores de fragilidad física de ancianos en asistencia ambulatorial / Family insuficiency and the condition and the physical frailty's components of elderly in ambulatorial care

RESUMO Objetivo analisar a relação entre insuficiência familiar e a condição e os marcadores de fragilidade física de idosos acompanhados em ambulatório de Geriatria e Gerontologia. Método estudo quantitativo e transversal realizado com 384 idosos (≥ 60 anos) selecionados por critérios pré-estabelecidos de inclusão e exclusão. Avaliaram-se a fragilidade física segundo o fenótipo da fragilidade e a insuficiência familiar pelo APGAR de Família. Analisaram-se os dados mediante a estatística descritiva e a análise univariada mediante o teste de qui-quadrado com nível de significância estatístico de p≤0,05. Resultados não houve associação entre insuficiência familiar e fragilidade física (p=0,344), entretanto, observou-se percentual de idosos frágeis com elevada Disfunção Familiar (22,2%) e moderada Disfunção Familiar (19,4%), maior que o observado entre os idosos com boa funcionalidade familiar (12,2%). Entre os idosos frágeis para o marcador "fadiga/exaustão", houve proporcionalidade direta ao grau de Disfunção Familiar e relação estatisticamente significativa ao escore total do APGAR de Família (p=0,001). Conclusão e implicações para a prática a insuficiência familiar no idoso está relacionada a outros fatores intrafamiliares e não exclusivamente à fragilidade física, no entanto, pode-se afirmar que o grau de fragilidade física entre os idosos é diretamente proporcional ao nível de Disfunção Familiar.

RESUMEN Objetivo analizar la relación entre insuficiencia familiar y la condición y los marcadores de fragilidad física de ancianos acompañados en ambulatorio de Geriatría y Gerontología. Método estudio cuantitativo y transversal realizado con 384 ancianos (≥ 60 años) seleccionados por criterios preestablecidos de inclusión y exclusión. La fragilidad física fue evaluada de acuerdo el fenotipo de la fragilidad y la insuficiencia familiar según el APGAR de Familia. Los datos fueron analizados por estadística descriptiva y el análisis univariada por prueba de chi-cuadrado con nivel de significancia estadístico de p≤0,05. Resultados no hubo asociación entre insuficiencia familiar y fragilidad física (p=0,344), sin embargo, han sido observados ancianos frágiles con elevada Disfunción Familiar (22,2%) y moderada Disfunción Familiar (19,4%), mayor que lo observado entre los ancianos con buena funcionalidad familiar (12,2%). Entre los ancianos frágiles para el marcador "fatiga/agotamiento" hubo proporcionalidad directa al grado de Disfunción Familiar y relación estadísticamente significativa a la puntuación total del APGAR de Familia (p=0,001). Conclusión e implicaciones para la práctica la insuficiencia familiar en el anciano está relacionada a otros factores intrafamiliares y no exclusivamente a la fragilidad física, sin embargo, se puede afirmar que el grado de fragilidad física entre los ancianos es directamente proporcional al nivel de Disfunción Familiar.

ABSTRACT Objective to analyze the relationship between family insufficiency and the condition and the markers of physical frailty of elderly people followed up in a Geriatrics and Gerontology outpatient clinic. Method a quantitative and cross-sectional study conducted with 384 elderly (≥ 60 years) selected by pre-established inclusion and exclusion criteria. Physical frailty was assessed according to the frailty phenotype and family insufficiency by the Family APGAR. Data was analyzed using descriptive statistics and univariate analysis using the chi-square test with a statistical significance level of p≤0.05. Results there was no association between family insufficiency and physical frailty (p=0.344), however, it was observed a percentage of frail elderlies with high Family Dysfunction (22.2%) and moderate Family Dysfunction (19.4%), higher than that observed among the elderly with good family functioning (12.2%). Among the frail elderly for the marker "fatigue/exhaustion", there was a direct proportionality to the degree of Family Dysfunction and a statistically significant relation to the total score of the Family APGAR (p=0.001). Conclusion and implications for the practice family frailty in the elderly is related to other intra-family factors and not exclusively to physical frailty, however, it can be stated that the degree of physical frailty among the elderly is directly proportional to the level of Family Dysfunction.

Gender and education inequalities in dynapenia-free life expectancy: ELSI-Brazil

ABSTRACT OBJECTIVE To estimate the dynapenia-free life expectancy among community-dwelling older Brazilian adults and evaluate gender-related and educational differences. METHODS This is a cross-sectional study. The data were obtained from the Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brazil - Brazilian Longitudinal Study of Aging), conducted from 2015 to 2016 in Brazil. Dynapenia is defined as low muscle strength (< 27kg for men and < 16kg for women), measured with a handgrip dynamometer. The dynapenia-free life expectancy was estimated using the Sullivan method based on the standard period life table and dynapenia prevalence, stratified by age groups, gender, and schooling. RESULTS A total of 8,827 participants, aged 50 and over (53.3% women), were investigated. The prevalence of dynapenia was 17.7% among men and 18.5% among women. The women live longer and with more years free of dynapenia than men. Those in the higher education category (four or more years) presented an advantage in the dynapenia-free life expectancy estimates. CONCLUSIONS The results of this study suggest the substantial impact of dynapenia on longer dynapenia-free life expectancy among older people. Understanding dynapenia prevalence and dynapenia-free life expectancy could assist in predicting care needs, as well as targeting efforts to delay the onset of complications related to it at older ages. Without the implementation of policy regarding dynapenia prevention, inequalities in health due to gender and socioeconomic status may continue to increase.

Hemodynamics and functional outcomes after resistance training in hypertensive and normotensive elderly: An experimental study

Abstract Aim: To evaluate the chronic effects of resistance training on resting blood pressure, handgrip strength, gait speed, and Timed Up and Go test (TUG) in normotensive and hypertensive elderly individuals. Methods: Experimental study based on TREND. Hypertensive patients were diagnosed by an independent doctor. Before and after 12 weeks of progressive resistance training, we evaluated blood pressure, heart rate, body composition, Timed Up and Go test, gait speed, and handgrip strength. Results: Sample consisted of 41 participants divided into two groups (normotensive n = 28; hypertensive n = 13). We observed significant values in the reduction of blood pressure levels only in the group of hypertensive participants. In functionality outcomes, we observed significant values in all tests and both groups. Outcomes contemplate effect sizes ranging from small to moderate. Conclusion: Progressive resistance training lowers resting blood pressure levels, increases handgrip strength, and improves physical functional performance. Although the normotensive group did not show a reduction in blood pressure levels, an improvement was observed in the functional physical tests.

Effects of isometric handgrip training on blood pressure among hypertensive patients seen within public primary healthcare: a randomized controlled trial

ABSTRACT BACKGROUND: Meta-analyses have demonstrated that isometric handgrip training (IHT) decreases blood pressure in hypertensive individuals. Nonetheless, most studies were conducted in laboratory settings and its effects in real-world settings remain unclear. OBJECTIVE: To analyze the effects of IHT on office and ambulatory blood pressure in hypertensive patients attended within primary healthcare. DESIGN AND SETTING: Randomized controlled trial conducted in primary healthcare units within the Family Health Program, Petrolina, Pernambuco, Brazil. METHODS: 63 hypertensive patients (30-79 years old; 70% female) were randomly allocated into IHT or control groups. IHT was performed three times per week (4 x 2 minutes at 30% of maximal voluntary contraction, one-minute rest between bouts, alternating the hands). Before and after the 12-week training period, office and ambulatory blood pressure and heart rate variability were obtained. The significance level was set at P < 0.05 (two-tailed testing) for all analyses. RESULTS: IHT significantly decreased office systolic blood pressure (IHT: 129 ± 4 versus 121 ± 3 mmHg, P < 0.05; control: 126 ± 4 versus 126 ± 3 mmHg, P > 0.05), whereas there was no effect on diastolic blood pressure (IHT: 83 ± 3 versus 79 ± 2 mmHg, P > 0.05; control: 81 ± 3 versus 77 ± 3 mmHg, P > 0.05). Heart rate variability and ambulatory blood pressure were not altered by the interventions (P > 0.05 for all). CONCLUSION: IHT reduced office systolic blood pressure in hypertensive patients attended within primary care. However, there were effects regarding diastolic blood pressure, ambulatory blood pressure or heart rate variability. CLINICALTRIALS.GOV IDENTIFIER: NCT03216317.

Fatores relacionados à capacidade física de membros superiores e inferiores de idosos quilombolas / Factors related to the physical capacity of upper and lower limbs in quilombola elderly people

Resumo Objetivou-se avaliar os fatores relacionados à capacidade física de membros superiores e inferiores em idosos quilombolas. Estudo transversal e analítico, realizado com a população idosa residente na comunidade quilombola Caiana dos Crioulos, Alagoa Grande, estado da Paraíba. As variáveis dependentes investigadas foram capacidade física de membros superiores e de membros inferiores. Foi realizada correlação de Spearman e regressão linear simples e múltipla (IC95%; p<0,05). O estudo foi realizado em conformidade com a Resolução 466/2012 do Conselho Nacional de Saúde do Ministério da Saúde. Foram avaliados 43 idosos. A análise bivariada mostrou correlação positiva entre FPM e PAF; entre FPM e CMB e correlação inversa entre a SPPB e a idade. O modelo múltiplo para FPM mostrou correlação significativa com a idade, CMB e anos de estudo (R2=0,374; p<0,05). Para a SPPB mostrou correlação significativa com a idade (R2=0,2524; p=0,001). Assim, a reserva de massa muscular, anos de estudo e idade foram fatores relacionados à capacidade física entre os idosos quilombolas. A observância criteriosa destes aspectos e a intervenção precoce podem preservar a capacidade física e garantir a inclusão produtiva e a autonomia econômica tão pleiteada na agenda social das comunidades.

Abstract This paper aimed to assess the factors related to the physical capacity of upper and lower limbs in quilombola older adults. This is a cross-sectional, analytic study performed with elderly residents in the quilombola community Caiana dos Crioulos, Alagoa Grande, Paraíba, Brazil. The researched dependent variables were the physical capacity of upper and lower limbs. It was performed the Spearman correlation and multiple and linear simple regression (95% CI; p<0.05). This work was performed per Resolution 466/2012 from National Health Council. Forty-three older adults were assessed. The bivariate analyses showed a positive correlation between handgrip strength (HGS) and physical activity (PA), between HGS and arm muscle circumference (AMC), and an inverse correlation between Short Physical Performance Battery (SPPB) and age. The multiple-model for HGS was significantly correlated with age, AMC, and years of study (R2=0.374; p<0.05). Regarding the SPPB, it showed a significant correlation with age (R2=0.2524; p=0.001). Therefore, the muscle mass reserve, years of study, and age were factors related to the physical capacity among quilombola older adults. The strict compliance of these aspects and the early intervention can preserve physical capacity and ensure the productive inclusion and economic autonomy so much sought in the communities' social agenda.

Resistência muscular periférica e inspiratória reduzida em pacientes com cirrose hepática: um estudo transversal / Reduced peripheral and inspiratory muscle endurance in patients with liver cirrhosis: a cross-sectional study

ABSTRACT BACKGROUND: Liver cirrhosis (LC) causes several musculoskeletal changes. OBJECTIVE: To test the hypothesis that the peripheral and inspiratory muscle endurance are reduced in patients with liver cirrhosis. METHODS: Twenty-one patients with LC (LC group; 61±14 years) and 18 age-matched subjects (control group; 56±17 years) had accepted to participate in this cross-sectional observational study. To assess peripheral muscle endurance, all volunteers performed a rhythmic handgrip exercise at 45% of their maximum voluntary contraction. A metronome was used to control the contraction-relaxation cycles at 60/min. The inspiratory muscle endurance was assessed using PowerBreath®. Participants underwent inspiratory muscle exercise at 60% of their maximal inspiratory muscle strength. The time until failure characterized the muscle endurance for both handgrip and inspiratory muscle exercises. Additionally, the quality of life of the participants was assessed. RESULTS: The muscle endurance was lower in the LC group when compared to the control group for both handgrip (67 vs 130 s, P<0.001) and inspiratory muscle exercises (40 vs 114 s, P<0.001). The peripheral muscle endurance was directly correlated with the total quality of life score (r=0.439, P=0.01) and to the following domains: fatigue (r=0.378 e P=0.030), activity (r=0.583, P=0.001), systemic symptoms (r=0.316, P=0.073) and preoccupation (r=0.370, P=0.034). The inspiratory muscle endurance was inversely correlated with the total quality of life score (r=0.573, P=0.001) and the following domains: fatigue (r=0.503, P=0.002), activity (r=0.464, P=0.004), systemic symptoms (r=0.472, P=0.004), abdominal symptoms (r=0.461, P=0.005), emotional function (r=0.387, P=0.02) and preoccupation (r=0.519, P=0.001). CONCLUSION: Both peripheral and inspiratory muscle endurance were lower in LC patients when compared to the control group.

RESUMO CONTEXTO: A cirrose hepática (CH) causa várias alterações musculoesqueléticas. OBJETIVO: Testar a hipótese de que as resistências dos músculos periféricos e inspiratórios estão reduzidas em pacientes com CH. MÉTODOS: Vinte e um pacientes com CH (grupo CH; 61±14 anos) e 18 indivíduos pareados por idade (grupo controle; 56±17 anos) aceitaram participar deste estudo observacional transversal. Para avaliar a resistência muscular periférica, todos os voluntários realizaram um exercício de preensão manual rítmica a 45% de sua contração voluntária máxima. Um metrônomo foi usado para controlar os ciclos de contração-relaxamento a 60/min. A resistência muscular inspiratória foi avaliada com o PowerBreath®. Os participantes foram submetidos a exercícios musculares inspiratórios a 60% de sua força muscular inspiratória máxima. O tempo até a falha caracterizou a resistência muscular para os exercícios de preensão manual e de músculos inspiratórios. Além disso, foi avaliada a qualidade de vida dos participantes. RESULTADOS: A resistência muscular foi menor no grupo CH quando comparada ao grupo controle tanto para os exercícios de preensão manual (67 vs 130 s, P<0,001) quanto para os músculos inspiratórios (40 vs 114 s, P<0,001). A resistência muscular periférica foi diretamente correlacionada com o escore total de qualidade de vida (r=0,439, P=0,01) e com os seguintes domínios: fadiga (r=0,030, P=0,378), atividade (r=0,378 e P=0,030), sintomas sistêmicos (r=0,316, P=0,073) e preocupação (r=0,370, P=0,034). A resistência muscular inspiratória foi inversamente correlacionada com o escore total de qualidade de vida (r=0,573, P=0,001) e com os seguintes domínios: fadiga (r=0,503, P=0,002), atividade (r=0,464, P=0,004), sintomas sistêmicos (r=0,472, P=0,004), sintomas abdominais (r=0,461, P=0,005), função emocional (r=0,387, P=0,02) e preocupação (r=0,519, P=0,001). CONCLUSÃO: As resistências musculares periférica e inspiratória foram menores nos pacientes com CH quando comparados ao grupo controle.

Análise do estado funcional e força muscular de adultos e idosos em Unidade de Terapia Intensiva: Coorte prospectiva / Analysis of functional status and muscle strength in adults and older adults in an intensive care unit: a prospective cohort study

Resumo Avaliar e correlacionar o estado funcional (EF) e a força muscular (FM) em adultos jovens, adultos e idosos em Unidade de Terapia Intensiva (UTI). Coorte prospectiva com 48 pacientes avaliando EF por meio do Functional Status Score for the Intensive Care Unit (FSS-ICU) e FM pelo Medical Research Council Sum-Score (MRC-SS) e força de preensão palmar (FPP), no despertar e na alta da UTI. Dados analisados pelos testes Kruskall-Wallis, Qui-quadrado, Wilcoxon e Correlação de Sperman. Na comparação do despertar em relação à alta, o EF e o MRC-SS foram maiores na alta em todos os grupos, com menor ganho nos idosos. A FPP aumentou bilateralmente na alta, exceto no grupo de adultos, pois apresentavam valores maiores no despertar. Na comparação dos grupos, o FSS-ICU foi maior nos adultos no despertar e alta, e a FPP-D menor nos idosos. O EF apresentou forte associação com a FM em adultos jovens e adultos, pois ambos apresentam progressiva melhora durante a permanência na UTI. Os idosos apresentam menor ganho do estado funcional, além de apresentarem menor força muscular desde o despertar. Estas variáveis apresentam importante associação apenas nos adultos jovens e adultos, considerando a natureza multifatorial do processo de adoecimento e incapacidade nos idosos.

Abstract The aim of this study was to analyze and assess the association between functional status (FS) and muscle strength (MS) in young adults, adults and older adults in an intensive care unit (ICU). We conducted a prospective cohort study with 48 patients. FS was assessed using the Functional Status Score for the Intensive Care Unit (FSS-ICU) and MS was measured using the Medical Research Council Sum-Score (MRC-SS) and by testing handgrip strength (HS). The assessments were performed on awakening and ICU discharge. The data were analyzed using the Kruskall-Wallis, chi-squared, Wilcoxon and Spearman's correlation tests. FS and MRC-SS scores were higher on ICU discharge in all groups. Gains were lowest in the older adult group. HS was greater in both hands on ICU discharge in all groups except the adults. FSS-ICU on both awakening and ICU discharge was highest in the adults; HS-R was lowest in the older adults. There was a strong association between FS and MS in the young adults and adults. FS and MS showed progressive improvement during ICU stay. Gains in FS and MS on awakening and ICU discharge were lowest among the older adults. Important associations were found between these variables in all groups except the older adults. This can be explained by the multifactorial nature of illness and incapacity in this group.

Prevalencia de debilidad muscular en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017

Background: Handgrip strength is an indicator of frailty in older people. Aim: To determine the prevalence of low handgrip strength in older Chilean adults. Material and Methods: A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. Results: Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. Conclusions: The prevalence of low grip strength increased substantially with age.

Sarcopenia in children and adolescents with chronic liver disease / Sarcopenia em crianças e adolescentes com doença hepática crônica

Abstract Objective: To investigate the occurrence of sarcopenia in children and adolescents with chronic liver disease. Methods: A series of cases, with patients aged 6-19 years of both genders, who were treated in Liver Outpatient Clinics. Weight, height, muscle strength (assessed by manual grip strength), and muscle mass (estimated through dual-energy X-ray absorptiometry) were measured. Sarcopenia was diagnosed based on the simultaneous presence of muscle mass and muscle strength déficits, defined as the values below the mean for muscle mass and strength of the studied population, according to gender. A descriptive analysis (mean and standard deviation) was performed, and the difference of means was calculated by Student's t-test. Results: A total of 85 patients were studied, mostly females (64.7%), with a mean age of 11.7 (SD = 3.4) years. Sarcopenia was identified in 40% of the patients. Muscle strength déficit was found in 54.1% of the subjects, and 50.6% showed muscle mass déficit. The mean muscle mass for males was higher than that for females (6.07; SD = 1.22 kg/m2 vs. 5.42; SD = 1.10 kg/m2; p = 0.016). However, there was no significant difference in sex-related muscle strength (male = 0.85; SD = 0.52 kgf/kgm2 and female = 0.68; SD = 0.30 kgf/kgm2; p = 0.113). Conclusion: The research findings identified that sarcopenia is a condition found in pediatric patients treated at a public referral institution for chronic liver disease.

Resumo Objetivo: Investigar a ocorrência de sarcopenia em crianças e adolescentes com hepatopatias crônicas. Métodos: Série de casos, constituído por pacientes entre 6 e 19 anos, de ambos os sexos, acompanhados em ambulatórios de especialidade em hepatopatias. Foram feitas medidas de peso, altura, força muscular (avaliada pela força de preensão manual) e a massa muscular estimada a partir da absorciometria por dupla emissão de raios X. O diagnóstico de sarcopenia baseou-se na presença simultânea de déficit de massa muscular e de força muscular. Adotaram-se como déficit os valores abaixo da média para massa e força muscular da população estudada, segundo sexo. Realizou-se análise descritiva (média e desvio-padrão), bem como a diferença de médias com o teste do t de Student. Resultados: Foram estudados 85 pacientes, a maioria do sexo feminino (64,7%), com média de 11,7 (DP = 3,4) anos. A sarcopenia foi identificada em 40% dos pacientes, 54,1% apresentaram déficit de força muscular e 50,6% déficit de massa muscular. A média da massa muscular para o sexo masculino foi maior do que no feminino (6,07; DP = 1,22 kg/m2 vs 5,42; DP = 1,10 kg/m2; p = 0,016). No entanto, não houve diferença significante para força muscular com relação aos sexos (masculino = 0,85; DP = 0,52 kgf/kgm2 e feminino = 0,68; DP = 0,30 kgf/kgm2; p = 0,113). Conclusão: Os achados da pesquisa identificaram que a sarcopenia é uma condição presente em pacientes pediátricos atendidos em uma instituição pública de referência para doença hepática crônica.

Evaluation of quality of life, functionality and disability in patients with systemic sclerosis in a university hospital / Avaliação da qualidade de vida, funcionalidade e deficiência em pacientes com esclerose sistêmica em um hospital universitário

INTRODUCTION: Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by progressive fibrosis of the skin and internal organs that promotes high morbidity and mortality. OBJECTIVE: To evaluate the functionality, disability and quality of life of patients with systemic sclerosis and to compare the clinical forms of the disease. METHODS: Cross-sectional, descriptive and analytical study performed at the Rheumatology Clinic of the Hospital das Clínicas of the Federal University of Pernambuco (HC-UFPE) from August 2018 to April 2019. The non-probabilistic, convenience sample consisted of 60 patients diagnosed with systemic sclerosis (SSc), followed at the Rheumatology outpatient clinic of the Hospital das Clínicas, Federal University of Pernambuco. To evaluate the outcomes, the following instruments were used: Cochin Hand Functional Scale (CHFS) for hand function; 12-Item Short-Form Health Survey (SF-12) for quality of life; and Scleroderma Health Assessment Questionnaire (SHAQ) for functionality and disability. RESULTS: The mean results for CHFS, SHAQ, SF-12 Physical Component Summary and SF-12 Mental Component Summary were 14.5 (6.0-29.75), 1.01±0.56, 35.04±8.09, 40.94±10.56, respectively. There were no significant differences in CHFS outcomes between patients with diffuse and limited forms of SSc, SHAQ and the mental component of SF-12. However, in the physical component of SF-12, a better score was found in patients with the diffuse form of the disease (p=0.04). CONCLUSION: Patients with SSc present an important impairment of hand function, quality of life and functional capacity, and those with limited cutaneous form present worse scores of the physical component in the evaluation of quality of life.

INTRODUÇÃO: A esclerose sistêmica (ES) é uma doença autoimune crônica que se caracteriza por fibrose progressiva da pele e órgãos internos, promovendo grande morbimortalidade. OBJETIVO: Avaliar a funcionalidade, incapacidade e qualidade de vida em pacientes com esclerose sistêmica e comparar as formas clínicas da doença. MÉTODOS: Estudo transversal, descritivo e analítico, realizado na Clínica de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), de agosto de 2018 a abril de 2019. A amostra não probabilística do tipo conveniência foi composta por 60 pacientes com diagnóstico de ES, acompanhados no ambulatório de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco. Para avaliar os resultados, foram utilizados os seguintes instrumentos: Escala Funcional da Mão de Cochin (CHFS) para função da mão; 12-Item Short-Form Health Survey (SF-12) para qualidade de vida; Questionário de Avaliação de Saúde da Esclerodermia (SHAQ) para funcionalidade e incapacidade. RESULTADOS: Os resultados médios para CHFS, SHAQ, SF-12 componente físico e SF-12 componente mental foram 14,5 (6,0-29,75), 1,01±0,56; 35,04±8,09; 40,94±10,56, respectivamente. Não houve diferenças significativas nos resultados do CHFS entre pacientes com formas difusas e limitadas de ES, SHAQ e o componente mental do SF-12. No entanto, no componente físico do SF-12, foi encontrado melhor escore dos pacientes com a forma difusa da doença (p=0,04). CONCLUSÃO: Pacientes com ES apresentam comprometimento importante da função da mão, qualidade de vida e capacidade funcional, e aqueles com forma cutânea limitada apresentam piores escores do componente físico na avaliação da qualidade de vida.

Entrenamiento de handgrip isométrico de alta intensidad en adultos mayores pre-hipertensos y con diagnóstico de hipertensión arterial sistémica etapa I / Effects high intensity isometric handgrip training on blood pressure of hypertensive older people

Background: Moderate isometric handgrip exercise is an effective tool in the management of systemic hypertension. Aim: To evaluate the effectiveness of a high intensity isometric handgrip exercise protocol for the reduction of blood pressure in older people with pre or stage-1 hypertension. Material and Methods: Twenty-three participants aged 73.8 ± 6.6 years (range 61-90) completed eight weeks of high intensity isometric handgrip training 2 times per week, performing 32 contractions maintained for 5 seconds, with breaks of 5 seconds. Blood pressure (BP) was measured at baseline and at the end of the intervention. Results: Systolic blood pressure decreased from 141 ± 11 to 127 ± 10 mmHg (p < 0.01). The decrease in diastolic blood pressure was from 79 ± 7 to 74 ± 6 mmHg (p < 0.01). Conclusions: A blood pressure reduction was recorded in these participants after a period of high intensity isometric handgrip exercise.

Longitudinal changes in nutritional parameters and resting energy expenditure in end-stage renal disease / Alterações longitudinais nos parâmetros nutricionais e gasto energético de repouso na doença renal em estágio terminal

Abstract Aims: To evaluate the nutritional status, resting energy expenditure, caloric and protein intake, and evolution of biochemical parameters in three stages of chronic kidney disease: pre-dialytic, at the beginning of the dialysis treatment, and 30 days after starting treatment. Methods: The chi-square and Student's t tests were used to compare the variables, and analysis of repeated measurements was used to compare the data obtained in the three moments evaluated. The results were discussed at the 5% level of significance. Results: We evaluated 35 patients, 60% female and 60% with diabetes mellitus. There was a decrease in midarm circumference and serum albumin. Inflammatory state and caloric and protein intake increased. There was no significant difference in resting energy expenditure in the three moments. The serum urea and serum albumin, handgrip strength, and protein consumption after 30 days from the start of dialysis were greater in the peritoneal dialysis patients, when compared to the hemodialysis population. Conclusion: there was a decrease in midarm circumference and serum albumin and an increase in protein intake after dialysis. The peritoneal dialysis patients had higher muscle strength, even with lower protein intake. Resting energy expenditure was not different between dialysis methods and the moments evaluated.

Resumo Objetivos: Avaliar o estado nutricional, o gasto energético em repouso, o gasto calórico e proteico e a evolução dos parâmetros bioquímicos em três estágios da doença renal crônica: pré-dialítico, no início do tratamento dialítico e 30 dias após o início do tratamento. Métodos: O teste do qui-quadrado e o teste t de Student foram utilizados para comparar as variáveis, e a análise das medidas repetidas foi utilizada para comparar os dados obtidos nos três momentos avaliados. Os resultados foram discutidos ao nível de significância de 5%. Resultados: Foram avaliados 35 pacientes, 60% mulheres e 60% com diabetes mellitus. Houve uma diminuição na circunferência do terço médio do braço (CMB) e na albumina sérica. O estado inflamatório e a ingestão calórica e protéica aumentaram. Não houve diferença significativa no gasto energético em repouso nos três momentos. A ureia sérica e a albumina sérica, a força de preensão manual e o consumo de proteínas após 30 dias do início da diálise foram maiores nos pacientes em diálise peritoneal, quando comparados com a população em hemodiálise. Conclusão: houve diminuição da circunferência do terço médio do braço e na albumina sérica, e aumento da ingestão protéica após a diálise. Os pacientes em diálise peritoneal apresentaram maior força muscular, mesmo com menor consumo proteico. O gasto energético em repouso não foi diferente entre os métodos de diálise e os momentos avaliados.