Relationship between lower-limb muscle strength and frailty among elderly people

Abstract

CONTEXT AND OBJECTIVE: Sarcopenia is the main factor involved in the development of frailty syndrome. The aims here were to investigate relationships between lower-limb muscle strength and the variables of sex, age and frailty criteria; compare lower-limb muscle strength with each frailty criterion; and assess the power of each criterion for estimating the risk of frailty among elderly outpatients. DESIGN AND SETTING: Cross-sectional study at the Geriatrics Outpatient Clinic of a university hospital in Campinas. METHOD: A non-probabilistic convenience sample of 150 elderly people of both sexes who were followed up as outpatients was assessed. Sociodemographic data (sex and age) and physical health data (frailty criteria and the five-times sit-to-stand test) were gathered. Descriptive, comparative and multivariate logistic regression analyses were performed. RESULTS:The majority of the elderly people (77.3%) were 70 years of age or over, with predominance of females (64.2%) and had a low score for the five-times sit-to-stand test (81.4% scored 0 or 1); 55.3% of the elderly people presented three or more frailty criteria. A significant association was found between lowerlimb muscle strength and the variables of age and number of frailty criteria. CONCLUSIONS: Lower levels of lower-limb muscle strength were associated with advanced age and greater presence of signs of frailty. Moreover, lower-limb muscle strength was also associated with the criteria of reduced walking speed criteria and hand-grip strength.reSUMO CONTEXTO E OBJETIVO: A sarcopenia é o principal fator envolvido no desenvolvimento da síndrome de fragilidade. O objetivo foi investigar a relação entre força muscular de membros inferiores e as variáveis sexo, idade e critérios de fragilidade; comparar a força muscular de membros inferiores com cada critério de fragilidade e verificar seu poder de estimativa do risco para fragilidade em idosos ambulatoriais. TIPO DE ESTUDO E LOCAL: Estudo transversal no Ambulatório de Geriatria de um hospital universitário de Campinas. MÉTODO: Foi avaliada uma amostra de conveniência não-probabilística de 150 idosos de ambos os sexos em acompanhamento ambulatorial, com coleta de dados sócio-demográficos (sexo e idade) e de saúde física (critérios de fragilidade e teste de levantar e sentar da cadeira cinco vezes consecutivamente). Foram realizadas análises descritivas, de comparação e de regressão logística multivariada. RESULTADOS: A maioria dos idosos (77,3%) apresentou idade igual ou superior a 70 anos, com predomínio do sexo feminino (64,0%) e baixo escore no teste de levantar e sentar da cadeira cinco vezes consecutivas (81,4% escore 0 ou 1), 55,3% dos idosos apresentaram três ou mais critérios de fragilidade. Verificou-se associação significativa entre a força muscular de membros inferiores e as variáveis idade e número de critérios de fragilidade. CONCLUSÕES: Menores níveis de força muscular de membros inferiores estão associados a idade avança-da e maior presença de sinais de fragilidade. Além disso, a for...

Transição entre níveis de fragilidade em idosos no município de Belo Horizonte, Minas Gerais

“…5,8,18 A study carried out in 2012 by Espinoza et al 5 observed that muscle strength and gait speed are the most prevalent variables in frail elderly persons. Associated with this, previous studies concluded that the reduction of muscle strength is not only the main variable that contributes to the establishment of the frailty syndrome, 19 but also that lower muscle strength identified in the baseline assessment is associated with a negative evolution of the phenotype. 18 Thus, it is believed that muscular strength and gait speed are of the utmost importance for elderly people, since it has been observed that loss of muscle mass 19 and low gait speed 20 are associated with negative outcomes in elderly persons, 20 among which are the establishment of frailty syndrome 19,20 and death.…”

Comparison of temporal and kinetic walking parameters among young people and falling and non-falling elderly persons

“…To be included in the "Young" and "Elderly NF" groups individuals could not have suffered a fall in the 12 months preceding the assessment, and be aged between 18 and 23 years, and 60 and 75 years, respectively. Individuals in the "Elderly F" group had to have suffered at least two falls in the 12 months prior to the beginning of the study and be aged between 60 and 75 years; adopting the criteria of Whitney et al 7 Individuals were not included in the sample if they (1) had a diagnosed neurological disease (2) had difficulty walking, including the use of mobility aids such as crutches, canes or walkers of any kind (3) had diagnosed, uncorrected visual deficits; (4) had orthopedic diseases that would make performing the tests impossible; (5) suffered from dizziness and/or uncontrolled chronic vestibular disorders; (6) used medications with documented effects on balance and gait (sedatives, tranquilizers, antidepressants or antiarrhythmic agents); (7) suffer from other serious musculoskeletal injuries or pain of any kind which could influence gait quality.…”

“…Thus, the occurrence of falls in the elderly is common, resulting in the increased morbidity and mortality of this population. 1,2 According to Siqueira et al, 3 34% of elderly individuals older than 60 have suffered from falls, and of these, 17.9% had their usual daily activities restricted by the event. Following the first fall, approximately 50% of these elderly individuals became recurring fallers, with two or more events every 12 months.…”

Sarcopenia and Frailty: the detectable overlapping and the possible diagnostic approaches

“…Then there is frailty which is considered a multi-system impairment that makes the individual vulnerable to stressors -being external or internal stressors and can lead to the occurrence of falls, disability, institutionalization and even mortality [5][6][7][8][9][10] . Regardless the fact that sarcopenia is more associated with the muscles and their degenerative changes and frailty is considered to be more related with components such as exhaustion, weakness, and slowness, both of them can be characterized as "geriatric syndromes with partly overlapping phenotypes" and there is a deeper connection between them since sarcopenia is involved -as a main factor, in the development of the frailty syndrome 7,[11][12][13] . Even though sarcopenia and frailty are considered highly prevalent in the elder population and correlated to impairment, are addressed as potentially reversible syndromes from the adulthood and easy-to-find in the everyday clinical practice 14 .…”