Sensibilidade e especificidade da força de preensão manual como discriminador de risco para multimorbidades em idosos

Abstract

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.Sensibilidade e especificidade da força de preensão manual como discriminador de risco para multimorbidades em idosos Sensitivity and specificity of hand grip strength as a risk discriminator for multimorbidities in the elderly ResumoObjetivo: Selecionar, por meio da sensibilidade e da especificidade, os melhores pontos de corte da força de preensão manual como discriminador de risco para presença de multimorbidades em idosos. Método: Estudo transversal, realizado com 310 idosos com idade ≥ 60 anos, de ambos os sexos, residentes no município de Ibicuí, Bahia. Para identificação da força de preensão manual como discriminador de risco para presença de multimorbidades, foi adotada a análise das curvas Receiver Operating Characteristic (ROC), com intervalo de confiança de 95%. Posteriormente, foram identificados os pontos de corte com suas respectivas sensibilidades e especificidades. Resultados: A área total sob a curva ROC entre a força de preensão manual e a presença de multimorbidades foi de 0,59 (IC 95% = 0,52-0,67) para mulheres e de 0,58 (IC 95% = 0,50-0,67) para homens. Os melhores pontos de corte para discriminar a presença de multimorbidade foram, para mulheres e homens, respectivamente, 15,35 kgf (sensibilidade de 69,7% e especificidade de 52,2%) e 24,8 kgf (sensibilidade de 49,5% e especificidade de 68,4%). Conclusão: Os resultados encontrados neste estudo sugerem que a força de preensão manual pode ser utilizada como discriminador de risco para presença de multimorbidades em idosos. Palavras-chave: saúde do idoso; predição; morbidade. AbstractObjective: Select through sensitivity and specificity the best cutoffs for hand grip strength as a risk discriminator for presence of multimorbidities in the elderly. Method: A cross-sectional study was conducted with 310 elderly individuals aged ≥60 years, of both genders, living in the municipality of Ibicuí, Bahia state, Brazil. Hand grip strength as a risk discriminator for presence of multimorbidities was identified by analysis of the Receiver Operating Characteristic (ROC) curves with 95% confidence interval. Subsequently, the cutoff points with their respective sensitivity and specificity values were identified. Results: The total area under the ROC curve between hand grip strength and presence of multimorbidities was 0.59, 95% CI (0.52-0.67) for women and 0.58, 95% CI (0.50-0.67) for men. The best cutoff points to discriminate presence of multimorbidities were 15.35 kgf (69.7% sensitivity and 52.2% specificity) and 24.8 kgf (49.5% sensitivity and 68.4% specificity) for women and men, respectively. Conclusion: Results suggest that hand grip strength may be used as a risk discriminator for presence of multimorbidities in the elderly.

Association Between Physical Functioning and Time Until a New Hospitalization in Community-Dwelling Older Adults: A Prospective Cohort Study

“…Handgrip strength was assessed using a Jamar handgrip dynamometer (Manufacturer Code, DINA-J; weight, 6010 kg; scale, 0-90 kgf; Brazilian Register ANVISA 80443119003), following a standardized protocol,18 considering the cut-off value of lower handgrip strength at 24.8 kgf (sensitivity, 49.3%; specificity, 68.4%; area under the curve [AUC], 0.58) and 15.35 kgf (sensitivity, 69.7%; specificity, 52.2%; AUC, 0.59) for men and women, respectively 19. Functional performance was evaluated according to the protocol proposed by the SPPB (internal consistency α= 0.725, interrater reliability intraclass correlation coefficient [ICC] = 0.996, intra-rater reliability ICC = 0.876),20 considering the cut-off value for poor functional performance at 7 (sensitivity, 60.0%; specificity, 79.0%) 21.…”

“…52.2%; AUC, 0.59) for men and women, respectively. 19 Functional performance was evaluated according to the protocol proposed by the SPPB (internal consistency α = 0.725, interrater reliability intraclass correlation coefficient [ICC] = 0.996, intra-rater reliability ICC = 0.876), 20 considering the cut-off value for poor functional performance at 7 (sensitivity, 60.0%; specificity, 79.0%). 21 Balance was assessed using the step test, considering the time taken to place the feet alternately on a standard step.…”

Análise da associação entre força de preensão manual e funcionalidade em pessoas idosas da comunidade

“…The hand grip strength (HGS) has been used as a general indicator of muscle strength and power in clinical practice 6,7 . In addition, the assessment of HGS is used as an indicator of global strength 8,9 and functionality 7,8 . However, not all studies have been able to demonstrate the existence of significant correlations between HGS and physical capacity 10,11 .…”

Analysis of the association between hand grip strength and functionality in community elderly

“…As a general indicator of muscle strength and power, in clinical practice, handgrip strength (HGS) has been used. 6 In addition, the evaluation of HGS is used as an indicator of global strength 8,9 and functionality 7,8 , however, not all studies have been able to demonstrate the existence of significant correlations between HGS and functional performance. 10 There are several ways to assess the functional status and level of physical fitness of the elderly., often by inference, because it is known that the worse the health status, the greater the negative impact on mobility, the ability to perform a submemal task and the independence of the elderly.…”