Fatores associados ao baixo peso em idosos comunitários de sete cidades brasileiras: Estudo FIBRA

Abstract

The aim of this study was to assess the prevalence of being underweight among the elderly according to demographic and socioeconomic characteristics, health-related behaviors, diseases and health status. This was a cross-sectional multi-center study with 3,478 community-dwelling elders (≥ 65 years). The dependent variable was the prevalence of being underweight, classified by Body Mass Index < 22kg/m2. Adjusted prevalence rate ratios were estimated using multivariable Poisson regression. The mean age was 72.9 years and 12.0% of the elderly were underweight (CI95%:10.9-13.1). Aged elderly ≥ 80 years, former and current smokers, those who reported appetite loss and those classified as pre-frail or frail (PR=1.41; CI95%:1.09-1.82) presented a higher prevalence of being underweight. Individuals who received medical diagnosis of hypertension, diabetes and rheumatism had the lowest underweight prevalence observed. The results highlight the importance of nutritional status assessment and monitoring among the elderly, with emphasis on the most vulnerable subgroups, particularly the frail elderly, taking into account the health consequences of low weight.

Prevalence and factors associated with underweight among Brazilian older adults

“…Hypertension was less prevalent among underweight older adults in the present study, which is in agreement with data reported in a previous study 7 . Ageing is accompanied by changes in vascular properties, such as hardening of the arteries, which plays an important role in the onset and progression of arterial hypertension 33 .…”

“…In the present study, underweight was more prevalent among smokers, which is in agreement with data found in the literature 7,19,20 . Analyzing 1954 individuals aged 60 years or older in four areas of the state of São Paulo, Zaitune et al 19 found a 90% higher prevalence rate of underwei- ght among smokers.…”

“…In the Brazilian older population, the prevalence of underweight (body mass index [BMI] < 22kg/m 2 ) is 19.9% and 18.2% among men and women, respectively, with higher rates found in those with an advanced age, those living in the northeastern and central regions of the country, those living alone and those with lower schooling and income 6 . In a study conducted with community-dwelling older adults (≥ 65 years) in seven Brazilian cities, the prevalence of underweight was 12.0% and was higher among those aged ≥ 80 years, former and current smokers, those who reported a loss of appetite and those classified as frail or pre-frail 7 . A systematic review of longitudinal studies found that age, polypharmacy, constipation, dementia, poor appetite and swallowing problems were among the risk factors that lead to malnutrition in older adults 8 .…”

Impacto do exercício físico em idosos com baixo peso: uma abordagem focada na sarcopenia

“…O envelhecimento é caracterizado pelo declínio de diversas funções orgânicas, influenciando na capacidade de manutenção da homeostase e acarretando na maior suscetibilidade a doenças. 1 No que diz respeito às alterações orgânicas, há alterações digestivas, ocasionando na baixa ingestão calórica e protéica e na consequente desnutrição. Há alterações endócrinas, diminuindo a reposição de GH, IGF-1, PTH, testosterona e estrógeno, que interferem na lipólise, síntese de proteínas, na modulação muscular, na quantidade de células satélites e na liberação de citocinas, respectivamente.…”

“…6 Uma vez que o processo de envelhecimento implica em alterações absortivas do TGI e na depleção de fibras musculares, o idoso mau nutrido e com baixo peso está sujeito a potencialização destes processos. 1 Estes fatores podem levar ao maior risco de morbimortalidade por quedas e fraturas. 7 A presente revisão objetivou verificar o impacto da prática de exercício físico em idosos com baixo peso e sarcopenia, visto que este último é um componente frequentemente associado à magreza na população idosa.…”