Background
Sarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia.
Methods
This was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index – BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05.
Results
Adjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53–0.76), CC (OR: 0.73; 95%CI: 0.62–0.85), WC (OR: 0.93; 95%CI: 0.90–0.97) and BMI (OR: 0.64; 95%CI: 0.53–0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia.
Conclusions
An increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.
BackgroundSickle Cell Disease (SCD), which is characterized by a mutation in the gene
encoding beta hemoglobin, causes bodily dysfunctions such as impaired
pulmonary function and reduced functional capacity. ObjectiveTo assess changes in pulmonary function and functional capacity in patients
with SCD and to identify the relationships between these variables.MethodWe evaluated sociodemographic, anthropometric, lung function (spirometry),
respiratory (manovacuometer), peripheral muscle strength (Handgrip strength
- HS) and functional capacity (i.e., the six-minute walk test) parameters in
21 individuals with SCD (average age of 29±6 years). Shapiro-Wilk,
paired Student's, Wilcoxon, Pearson and Spearman correlation tests were used
for statistical analyses, and the significance threshold was set at
p<0.05. ResultsA total of 47.6% of the study subjects exhibited an altered ventilation
pattern, 42.8% had a restrictive ventilatory pattern (RVP) and 4.8%
exhibited a mixed ventilatory pattern (MVP). The observed maximal
inspiratory pressure (MIP) values were below the predicted values for women
(64 cmH2O), and the maximum expiratory pressure (MEP) values, HS
values and distance walked during the 6MWT were below the predicted values
for both men (103 cmH2O, 39 Kgf and 447 m, respectively) and
women (64 cmH2O; 27 Kgf; 405 m, respectively). Positive
correlations were observed between maximum voluntary ventilation (MVV) and
MEP (r=0.4; p=0.046); MVV and BMI (r=0.6; p=0.003); and between HS and MIP
(r=0.7; p=0.001), MEP (r=0.6; p=0.002), MVV (r=0.5; p=0.015), distance
walked in the 6MWT (r=0.4; p=0.038) and BMI (r=0.6; p=0.004). ConclusionsSCD promoted changes in lung function and functional capacity, including RVPs
and a reduction in the distance walked in the 6MWT when compared to the
predictions. In addition, significant correlations between the variables
were observed.
The association between the Short Physical Performance Battery (SPPB) score and several adverse health outcomes, including mortality, has been reported in the scientific literature. We conducted a comprehensive literature review of studies on the relationship between SPPB and mortality. The current paper synthesizes the characteristics and main findings of longitudinal studies available in the literature that investigated the role of the SPPB in predicting mortality in older adults. The studies (n = 40) are from North America, South America, Europe, and Asia; the majority (n = 16) were conducted with community-dwelling older adults and reported an association between lower SPPB scores and a higher risk of mortality, and between higher SPPB scores and higher survival. Nevertheless, few studies have analyzed the accuracy of the instrument to predict mortality. The only study that established cut-off points was conducted with older adults discharged from an acute care hospital. Although an SPPB score lower than 10 seems to predict all-cause mortality, further studies showing cut-off points in specific settings and loco-regional specificities are still necessary.
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