Prevalência da obesidade, obesidade sarcopênica e fatores associados em idosos comunitários: um estudo da Rede fibra

Abstract

The sarcopenic obesity (SO) is characterized by excess of body fat and deficit of mass and muscle strength, related to some functional issues. The aim was to identify the prevalence of obesity, SO and sociodemographic factors, health conditions and measures of physical performance associated with SO in an elderly community. Accessing the database of FIBRA project (Group of Study of Frailty in the Brazilian Elderly), a sample of 1373 elderly with 65 years old or more, with no cognitive impairment, able to walk independently living in three different cities was collected and divided into three groups: 1) Nonobese; 2) Nonsarcopenic obese; 3)Sarcopenic obese. The SO was set by BMI 30 kg/m² and hand grip strength below the 20 percentile of the sample. Sociodemographic outcomes were sex, age, city, years of education and marital status. Health outcomes were number of medicine taken, self-reported diseases, hospitalization in the last year and a self-reported falls in the last 12 months. Physical performance was measured by the Instrumental Activities of Daily Living (IADL), questionnaire of Advanced Activities of Daily Living (AADL) and walking speed to go 4.6 meters. Frailty was based on the phenotype of Fried et al., (2001). Descriptive statistics was used to explore the selected inputs. The associations between SO and continuous variables were tested by biserial correlation coefficient (rb). Between qualitative variables, the chi-square (2) distribution was applied. Multivariate logistic regression models were used to identify associations between physical performance, frailty and SO. The prevalence of obesity was 25.85% (n = 355) and of sarcopenic obesity was 4.44% (n = 61). Among the obese, 17.18% were also sarcopenic. Among SO, 36.1% (n = 22) were frail and 59% (n = 36) were pre-frail. Walking speed average for SO group (0,79m/s ± 0.23) was significantly lower than the nonsarcopenic obese group (0.93 ± 0.27; p<0.001) and the nonobese group (0.99 ± 0.28; p<0.001). An increase of 0.1m/s in walking speed reduced by an average 85.1% the chance of having SO (â = -1.906, p <0.0001; Exp(B)= 0.149; CI95%: 0.051 a 0.434). Being SO increased 14.2 times the chance of being pre-frail (â = 2.65; p <0.0001; OR = 14.21; 95% CI: 4.28 to 47.23) and 112.9 times the chance of being frail (â = 4.73, p <0.0001; OR = 112.93; CI95%: 28.83 to 442.37). The results showed a prevalence of obesity among the elderly, higher than the national average. However, the rate was similar to the average found for the group of older people with the same average age and gender of the sample. The prevalence of OS was similar to other studies with similar definitions for SO. There was also a significant increase in the chance of being pre-frail and frail, which demonstrates how important is to screen the elderly with SO for frailty syndrome. Walking speed can be a useful tool for monitoring the progression of the SO, since greater walking speed significantly reduced the chance of an elderly being a SO one.