Relação entre indicadores de sarcopenia, nível de atividade física, funcionalidade e fragilidade em idosos

Abstract

Introduction: frailty and sarcopenia are highly prevalent syndromes in the elderly and they usually overlap. However, there are few studies that used indirect measures of sarcopenia and its associations with frailty and the implications on functional status and physical activity level. Objectives: to assess the relationships between indirect indicators of sarcopenia, frailty inactivity and its functional implications. Methods: a cross-sectional study of a sample of 53 elderly ( 65 years) recruited through active search at a secondary health care service. To assess sarcopenia we used five indirect measures: Body Mass Index (BMI), nutritional status (Mini Nutritional Assessment short form), gait speed on a six-meter course, physical activity level (Profile of Human Activity) and handgrip strength (JAMAR dynamometer). Frailty was characterized by Frieds phenotype composed by the following measures: unintentional weight loss, low physical activity, exhaustion, weakness and slow walking. For the functional status assessment the Short Physical Performance Battery test was used and the Profile of Human Activity was used to assess physical activity level. Results: from the 53 elderly assessed, 75% were women with mean age of 76.72 years (±5.89). About 30% of the sample was non-frail, 54.7% pre-frail and 15.1% frail. Physical activity level (41.5%) and gait speed (39.6%) were the most prevalent indirect indicators of sarcopenia. Physical activity level showed differences between the frailty groups (p<0.001), except within pre-frail and frail, and it was significantly correlated (p=0.004; r= 0.394) with the total score of the functional test. On the regression model this item, alone, explained 54.5% (R=0.545) of the increase on the positive frailty items. Gait speed showed differences (p=0.007) between non-frail and frail elderly and was also correlated with the functional test (p=0.000; r= - 0.525) and depressive symptoms (p= 0.003; r= 0.397). Handgrip strength was the only indirect indicator of sarcopenia that showed differences between fallers and non-fallers and nutritional status was correlated to the total score of the functional test (p=0.000; r=-0.88). Conclusions: this study confirmed the idea of the association between frailty and sarcopenia, and showed that inactivity and gait speed are important factors to track the syndrome, aiming to prevent or attenuate its negative effects, especially on the functional status of the elderly. We also pointed out to the importance of psychological outcomes (depressive symptoms) interfering on elderlys welfare.