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.
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.
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.
The practice of polypharmacy in the elderly has often been related to adverse effects, drug interactions, hospitalizations and prolonged hospitalization. In this sense, the objective of the study was to determine the prevalence of polypharmacy in the elderly and to identify the factors associated with this practice using the classification of 3 or more medications. A cross-sectional, population-based and home-based study including 316 elderly (age ≥ 60 years) from a small municipality was conducted. The use of polypharmacy was considered as the concomitant use of 3 or more drugs, and sociodemographic, behavioral and health conditions were collected through a questionnaire. The average age of the elderly was 74.2±9.8 years, with 54.7% being female. The prevalence of elderly who used three or more medications (polypharmacy) was 40.8%; of these, 56.8% reported being hypertensive, 80% diabetic and 65.2% with multimorbidity. In the adjusted analysis, polypharmacy was associated with females (
Introdução: O termo polifarmácia é utilizado para traduzir o uso de vários medicamentos, e sua prática em idosos tem sido frequentemente relacionada a efeitos adversos, interações medicamentosas, internações hospitalares e internamento prolongado. Acrescido a esses fatos, deve-se levar em consideração ainda, as particularidades fisiológicas dos idosos, pois estes possuem alterações farmacocinéticas (aumento da gordura corporal, redução da água corporal, redução do metabolismo hepático e da excreção renal) e farmacodinâmicas que podem modificar a ação dos medicamentos. Objetivo: Quantificar a utilização de polifarmácia e identificar os fatores associados a essa prática entre idosos residentes em comunidade. Métodos: Foi realizado um estudo de corte transversal, de base populacional e domiciliar. A população do estudo era composta por 355 idosos, no qual foram registrados 17 (4,8%) recusas e 22 (6,2%) não foram encontrados após três visitas domiciliares em dias alternados, sendo consideradas perdas, resultando em população final de 316 (89%) idosos. Para a coleta de dados foi utilizado um formulário específico, baseado no questionário utilizado na Pesquisa Saúde, Bem-Estar e Envelhecimento (SABE), realizado em sete países da América Latina e do Caribe. O uso de polifarmácia foi considerado como a utilização concomitante de 3 ou mais medicamentos, as variáveis sociodemográficas, comportamentais e condições de saúde foram coletadas por meio de um questionário próprio e o nível de atividade física pelo International Physical Activity Questionnaire. Resultados: Participaram do estudo 316 idosos com idade média de 74,2 ± 9,8 anos, sendo 54.7% do sexo feminino. Na análise ajustada, a polifarmácia esteve associada ao sexo feminino (RP = 1,40; IC95%: 1,08-1,81; p = 0,011), naqueles com faixa etária de 70 a 79 anos (RP = 1,58; IC95%: 1,18-2,11; p = 0,002), nos insuficientemente ativos (RP = 1,41; IC95%: 1,11-1,78; p = 0,005), hipertensos (RP = 2,37; IC95%: 1,24-4,52; p = 0,009), diabéticos (RP = 1,49; IC95%: 1,22-1,82; p < 0,001) e com duas ou mais doenças crônicas (RP = 4,35; IC95%: 1,20-15,73; p = 0,025). Conclusão: Observou-se uma elevada prevalência de idosos que faz uso da polifarmácia, neste sentido a abordagem terapêutica na população idosa constitui um desafio para os prescritores e para o Sistema Único de Saúde, sendo de suma importância que seja avaliado não só o número de medicamentos, mas também as classes e doses empregadas, uma vez que as propriedades farmacocinéticas e farmacodinâmicas devem ser levadas em consideração, bem como as interações medicamentosas e a possibilidade do uso de medicamentos inapropriados para idosos.
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