Estado nutricional e fatores de risco para demência em uma população de idosos frágeis

Abstract

The elderly population is increasing worldwide. The natural trends of primary aging lead to a nutritional status influenced by the reduction of taste, food intake, metabolism, maximal oxygen uptake, muscle mass, strength and physical activity. Consequently, the neuromuscular system becomes limited by musculoskeletal losses, reduction of alpha motor neurons of the spinal cord, degeneration of axons and recruitment of motor units. Weakness is linked to these consequences. The malnutrition induced by intaking reduced proteins and calories, physical inactivity, tobacco and other stressor agents can increase ROS (Reactive Oxygen Species), which are increased by aging. Antioxidant substances such as vitamins can not neutralize ROS causing an imbalance between oxidants and antioxidants substances with activation of routes that lead to cell loss, characteristic of neurodegenerative processes. Proteolytic routes are activated where more degradation than protein synthesis happen leading to loss and atrophy of muscle fibers. Inflammatory routes are also activated with production of cytokines and neurotrophins attempting to maintain homeostasis. The interaction among nervous, immune and endocrine systems is fundamental to maintaining the body balance. This paper aims tracing the socio-demographic profile of elderly registered in a Basic Health Unit, characterizing fragile and no fragile elderly population under the biological, inflammatory and cognitive aspect through the Mini Text of the Mental Status (MEEM), identifying the nutritional status of the elderly, evaluating the correlation with MEEM scores. The methodology will be characterized by a cross-sectional study, considering the samples will be consisted of elderly over the age of 65. The cognitive screening shall be conducted by MEEM, through which it will be possible to distinguish two groups: one that presents cognitive impairment and the other that doesn't present cognitive impairment. The anthropometric data consists of weight, height, circumferences: abdominal, calf and arm. The classification of nutritional status will be reviewed by BMI and evaluation of vitamins, whereas the biological parameters will be evaluated using ELISA (Enzyme-linked immusorbent assay) method. The fragility will be measured by the components: grip strength, walking speed, physical activity, self-reported of weight loss and fatigue.