ResumoObjetivo: Identificar a prevalência e os fatores associados a quedas e quedas recorrentes em uma amostra de idosos que vivem na comunidade no município de Cuiabá-MT. Métodos: Estudo transversal, de base populacional, com idosos de 65 anos ou mais. Os domicílios foram arrolados por meio do sorteio de regiões censitárias, de acordo com a densidade populacional e o número de idosos em cada região. Foi utilizado um inquérito multidimensional contendo dados sociodemográficos, clínicos, psicológicos, de desempenho funcional e uma bateria de testes físicos. Resultados: A amostra foi composta por 391 participantes, com idade média (dp) de 72,4 (6,0) anos. Do total de participantes, 37,5% referiram ter caído no último ano e 16,5% relataram duas ou mais quedas. Cair foi associado a sintomas depressivos (OR=1,96; 95% IC 1,22-3,14, p=0,005); morar só (OR=2,83; 95% IC 1,57-5,12, p<0,001); baixa autoeficácia para quedas (OR=1,77; 95% IC 1,10-2,83, p=0,017); e artrite (OR= 2,10; 95% IC 1,34-3,29, p=0,001). Cair recorrentemente foi associado a: gênero feminino (OR=2,54; 95% IC 1,23-5,21, p=0,011); ter 80 anos e mais (OR=2,30; 95% IC 1,12-4,72, p=0,022); queixa de tontura (OR=1,91; 95% IC 1,04-3,49, p=0,035); morar só (OR=2,57; 95% IC 1,18, p=0,008); artrite (OR=1,94; 95% IC 1,51, p=0,027); e sintomas depressivos (OR=2,13 95% IC 1,88, p=0,013). Conclusão: Os fatores associados a quedas e quedas recorrentes modificáveis foram morar só, ter sintomas depressivos, baixa autoeficácia para quedas, tontura e artrite. Sugere-se que esses fatores sejam considerados em programas de prevenção de quedas nesta população.
Background Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID‐19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID‐19 patients. Methods We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS‐CoV‐2 during hospitalization and were excluded from the analyses. Results The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (±15) years, body mass index of 29.5 (±6.9) kg/m2. The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07–2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex‐specific mean and standard deviation (1.23 [95% CI: 1.06–1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 ± 6.1 days) versus others (9.2 ± 8.4 days). Evidence of associations were also present for vastus lateralis cross‐sectional area. The crude HR identified shorter hospital stay for patients with greater sex‐specific standardized values (1.20 [95% CI: 1.03–1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross‐sectional area (0.63 [95% CI: 0.46–0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross‐sectional area was longer (10.8 ± 8.8 days) versus others (7.7 ± 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross‐sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID‐19, which stresses the value of muscle health in prognosis of this disease.
ObjectivesThis study evaluated the relationship between the skeletal muscle mass (SMM), obtained by predictive equations, and the body composition, nutritional aspects, functionality and physical performance in elderly people.MethodsThe sample consisted of adults aged 65 years or over from the cross-sectional study of the Brazilian Elderly Frailty Study Network, in Cuiabá, Mato Grosso State, Brazil. The anthropometric parameters, instrumental activities of daily living (IADL), Short Physical Performance Battery (SPPB), and handgrip strength (HGS) were evaluated. The SMM was estimated by 2 predictive anthropometric equations.ResultsBoth SMM equations correlated with age, anthropometric indices, SPPB, IADL, and HGS. However, only HGS and neck circumference strongly correlated in both equations, being higher in SMM II.ConclusionsIt seems that both equations are sensitive to obtain the SMM, contributing to the diagnosis of sarcopenia, nutritional status, and a physical performance condition.
Background Among the undesirable changes associated with obesity, one possibility recently raised is dysbiosis of the intestinal microbiota. Studies have shown changes in microbiota in obese rats and humans, but there are still few studies that characterize and compare the fecal microbiota of lean, obese and dogs after weight loss. Thus, this study aimed to evaluate the effects of a weight loss program (WLP) in fecal microbiota of dogs in addition to comparing them with those of lean dogs. Twenty female dogs of different breeds, aged between 1 and 9 years were selected. They were equally divided into two groups: Obese group (OG), with body condition score (BCS) 8 or 9/9, and body fat percentage greater than 30%, determined by the deuterium isotope dilution method, and lean group (LG) with BCS 5/9, and maximum body fat of 15%. Weight loss group (WLG) was composed by OG after loss of 20% of their current body weight. Fecal samples were collected from the three experimental groups. Total DNA was extracted from the feces and these were sequenced by the Illumina methodology. The observed abundances were evaluated using a generalized linear model, considering binomial distribution and using the logit link function in SAS (p < 0.05). Results The WLP modulated the microorganisms of the gastrointestinal tract, so that, WLG and LG had microbial composition with greater biodiversity than OG, and intestinal uniformity of the microbiota (Pielou’s evenness index) was higher in OG than WLG dogs (P = 0.0493) and LG (P = 0.0101). In addition, WLG had values of relative frequency more similar to LG than to OG. Conclusion The fecal microbiota of the studied groups differs from each other. The weight loss program can help to reverse the changes observed in obese dogs.
RESUMO: Atualmente, vem ocorrendo um aumento importante no número de pacientes idosos submetidos a internação hospitalar, mantidos em casas de repouso ou atendidos em regime ambulatorial, cujo estado nutricional pode ser considerado crítico. Assim, é fundamental que as alterações próprias do envelhecimento sejam o mais precocemente possível diferenciadas dos sinais clínicos de desnutrição. Um alto grau de suspeita clínica de pacientes idosos desnutridos, e que, conseqüentemente, necessitam de terapêutica nutricional, pode ser obtido por meio da história clínica, exame físico e dados laboratorias apropriados. A má nutrição que ocorre no idoso pode ser devida às alterações fisiológicas do envelhecimento, às condições sócio-econômicas, às doenças e à interação entre nutrientes e medicamentos. Assim sendo, as principais causas de má nutrição podem ser catalogadas como secundárias ao envelhecimento, menor rendimento econômico, isolamento, a morte de entes queridos, doenças e outros fatores relacionados. Como resultado, o idoso apresenta sério comprometimento do estado geral e uma maior morbidade e mortalidade em geral. A intervenção nutricional utiliza nutrientes, como fármacos, visando o tratamento de doenças. Por fim, as recomendações têm por objetivo indicar a quantidade mínima de nutrientes que seria adequada para a maioria das pessoas em seu ambiente usual, sem traumas ou doenças. No entanto, as recomendações, para o idoso são extrapoladas das recomendações obtidas para crianças e adultos jovens, nem sempre próprias para o idoso.
Modelo do Estudo: estudo de prevalência. Introdução : Há relatos do aumento da prevalência de dislipidemias com o envelhecimento. Há poucos estudos associando a obesidade centrípeta com a dislipidemia e há, ainda, que se determinar a real influência da obesidade abdominal sobre os níveis plasmáticos de lípides em idosos. Objetivo : Avaliar a possível associação entre a medida da circunferência abdominal, marcadora de gordura visceral, e os níveis de lípides no sangue. Métodos: O estudo foi realizado em 98 pacientes com 60 a 79 anos de idade, moradores do Distrito Oeste da cidade de Ribeirão Preto, sendo que 58 eram mulheres. A idade média dos voluntários foi de 66,3 anos. Foram colhidos os seguintes dados: circunferência abdominal, circunferência do quadril, triglicérides, colesterol total e HDL colesterol. A circunferência abdominal foi o parâmetro para a obesidade centrípeta.Resultados: Não houve associação entre colesterol total e circunferência abdominal (p = 0,88). Quando separamos pelo gênero verificamos que também não houve associação (p=0,73 e p=0,60 para homens e mulheres, respectivamente). A associação entre triglicérides e circunferência abdominal foi significativa (p<0,0001), mas ao separar por gêneros, houve associação entre triglicérides e circunferência abdominal nas mulheres (p=0,002) enquanto que nos homens não houve associação (p=0,07). Houve associação negativa entre HDL e circunferência abdominal (p=0,018), porém quando os gêneros foram analisados separadamente a associação entre HDL e circunferência abdominal não foi significativa (p=0,40 e p=0,07 para homens e mulheres, respectivamente). Conclusão: Provavelmente, em idosos, o risco cardiovascular advindo da obesidade centrípeta não tem na sua etiologia, exclusivamente, o aumento de lípides do sangue.
Objectives: The aim of this study was to evaluate the most commonly used body composition tools in clinical practice, such as anthropometry and electrical bioimpedance, and compare it with deuterium oxide. Methods: An exploratory cross-sectional study was conducted on women aged 100 years or above at home. Body composition was determined by measuring skinfolds (Jackson and Pollock and Durnin and Womersley equations), by bioimpedance, and by the deuterium oxide method. Results: Body mass index values were lower than 22 kg/m2 in 64% of the subjects. When the various methods used were compared with deuterium oxide, there was better agreement for the determination of fat mass than lean mass. For fat mass, agreement was better when using bioimpedance (Lin’s coefficient = 0.70), whereas for lean mass, agreement was better using the Durnin and Womersley equation (Lin’s coefficient = 0.51). Conclusion: It is possible to use bioimpedance and skinfolds to evaluate fat mass and lean mass, respectively, in centenarians.
However, sarcopenia cannot be considered only in relation to age, but as a multidimensional geriatric syndrome 4 , given its high prevalence in the elderly, since more than 50% of the population over 80 years old suffers from this medical condition 5,6. In addition to the inherent aspects of aging itself, it is determined by genetic predisposition, life habits, changes in living conditions, and chronic diseases 7 , which may contribute to the weakness and loss of independence in daily activities 8 , still being an independent predictor of hospitalization, disability, and death 9. In recent years, some experts have created consensus on a broader diagnosis of sarcopenia: The European Working Group on Sarcopenia in Older People (EWGSOP), which recommends a diagnosis based on decreased muscle mass, Abstract Objectives: There is little information about the risk factors for sarcopenia and dynapenia. This study aimed to assess the prevalence of sarcopenia and dynapenia and to verify which risk factors are associated with the elderly population. Methods: A total of 387 elderly people were evaluated. We used a questionnaire to identify sociodemographic and behavioral aspects. For physical performance, we used the Short Physical Performance Battery. Using the European Working Group of Sarcopenia in Older People consensus, we defined sarcopenia that includes the occurrence of low muscle mass, added to low muscle strength or low physical performance. Dynapenia was defined using handgrip strength. Results: Sarcopenia and dynapenia were identified in 15.3% and 38.2% of the elderly people, respectively; 15.8% of women and 14.2% of men had sarcopenia, and 52.4% of women and 13.5% of men had dynapenia. Sarcopenia was associated with the increase in aging, white race, smoking, and risk of malnutrition. Dynapenia is more likely to occur in women and hospitalized patients. Conclusion: Sarcopenia had a greater association with the risk factors evaluated here, mainly with smoking and nutritional status. On the other hand, dynapenia was different, having a greater association with hospital intervention.
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