Associação entre sarcopenia e os domínios da capacidade intrínseca: mobilidade e vitalidade em pessoas idosas cadastradas nas unidades básicas de saúde de Belo Horizonte e Diamantina: dados transversais do ICOPE Brasil viabilidade

Abstract

Introduction: Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, compromises functional capacity and quality of life in older adults. Intrinsic capacity, a concept proposed by the World Health Organization (WHO), encompasses domains such as mobility and vitality, and is considered essential in geriatric assessment. Objective: This study investigated the presence of Sarcopenia and its association with two domains of intrinsic capacity, as proposed by the WHO—mobility and vitality—in older adults receiving care at Primary Health Care services in municipalities of a developing country. Methods: A cross-sectional study was conducted with 323 older adults registered at Primary Health Care Units in Belo Horizonte and Diamantina, Brazil. Sarcopenia was diagnosed according to the 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) guidelines, using handgrip strength (measured by the Jamar dynamometer), skeletal muscle mass (estimated via bioelectrical impedance analysis), and physical performance (evaluated with the Short Physical Performance Battery – SPPB). Gait speed was used to assess mobility, and vitality was evaluated using the Mini Nutritional Assessment (MAN). Results: The mean age of participants was 70.7 ± 7.6 years, with a predominance of women (65.7%). The prevalence of Sarcopenia was 25.6%, higher in Diamantina (32.7%) compared to Belo Horizonte (21.5%). Older adults with Sarcopenia had lower gait speed (0.72 m/s vs. 0.85 m/s; p < 0.01) and lower vitality scores on the MAN (10.1 vs. 11.3; p = 0.02). In Diamantina, Sarcopenia was more strongly associated with reduced mobility (OR = 2.15; p = 0.03), whereas in Belo Horizonte, it was more closely linked to lower vitality (OR = 1.87; p = 0.04). After adjustment, no significant association was found in the overall model; however, specific regional differences were evident. Conclusion: Sarcopenia negatively affects both gait performance and nutritional status in older adults, with distinct patterns observed across different settings. Region-specific strategies focusing on mobility enhancement and nutritional interventions are essential to preserve intrinsic capacity and prevent functional decline within primary care.