Aim The objective of the present study was to evaluate the effect of dynapenia, central obesity and the presence of chronic diseases in 8‐year mortality of community‐dwelling older adults. Methods Participants comprised 610 older adults, aged ≥65 years at baseline, who participated in the “Frailty in Brazilian Older People” study carried out in 2008. Baseline data, such as weight, height, waist circumference, muscle strength, sex, self‐reported diseases and physical activity, were assessed. Vital status in 2016 was assessed by Mortality Information System database of Campinas. The χ2‐test and Mann–Whitney U‐test were used to compare categorical and continuous variables, respectively. Path analysis was carried out to study the factors associated with mortality. Results There was a statistical difference between alive and deceased groups for the variables sex, age group, physical activity, waist circumference and dynapenia. Path analysis explored the relationship among the studied variables. Direct paths showed a positive association to mortality for those who presented the combination of more diseases (β = 0.105), male sex (β = 0.108), low physical activity (β = 0.121), low handgrip strength (β = 0.090) and no central obesity (β = −0.143). When indirect paths were concerned, variables “central obesity”, the presence of “more diseases” and dynapenia had a mediator role. Conclusions Central obesity was not positively associated with higher mortality, unless it was associated with the presence of chronic diseases. Dynapenia showed a direct effect on mortality, but not combined with central obesity. The findings of this study shed light on complex relationships between nutritional status and elderly mortality through the use of simple measurements. Geriatr Gerontol Int 2019; 19: 108–112.
Background and objective: Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, the aim of this study is to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest old adults. Methods: This is a longitudinal prospective study using data from FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants who were interviewed with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had a greater number of IADL dependencies at follow‐up than at baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities, in relation to the group with stable weight, controlling for covariates (gender, age, education and morbidity). An alpha level <5% was adopted. Results: During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated to higher risk of functional decline (OR=2.74;p=0.032). Conclusions: weight loss consisted in a risk factor to functional decline in this sample of oldest old, but severity of the loss must be considered as only severe loss was significant. Given that weight loss is expected for the oldest old, it is important to quantify this loss and measure its severity, and also to identify the magnitude of the loss that is associated with functional decline.
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