Karla Helena Coelho Vilaça

Body composition, physical performance and muscle quality of active elderly women

Fat gain is one of the major factors aggravating physical disability in the elderly population, which presents an increase in fat mass and a decrease in lean mass compared to the young population. For this reason it is important to assess body composition and the effects of these alterations in obese elderly women. The purpose of this study was to assess body composition, physical performance and muscle quality in active elderly women. Cross-sectional study included 75 elderly women (29 eutrophic and 46 obese) 65-80 years old. Body composition was evaluated by dual energy X-ray absorptiometry (DXA) and the physical performance was determined by 6-minute walk test (6MWT), handgrip strength (HS) and knee extension strength (KES). Muscle quality was calculated as the ratio between muscle strength and lean mass. Fat free mass, lean mass, fat mass and percent body fat were significantly higher in the obese group (p<0.05). Furthermore, the obese group showed a poorer performance than the eutrophic group in the 6MWT (432.31±66.13 m and 472.07±74.03 m, respectively, p=0.01). HS and KES did not differ between groups, however, regarding muscle quality, the obese group exhibited a impaired in comparison to the eutrophic group in the upper (11.45±2.57 kg and 13.31±2.03 kg, respectively, p<0.01) and lower limb (2.91±1.16 kg and 3.44±0.97 kg, respectively, p=0.05). The increase in muscle mass detected in the obese elderly was not sufficient to maintain adequate muscle quality and physical function, showing a negative influence of the excess of body fat.

Body composition, muscle strength and quality of active elderly women according to the distance covered in the 6-minute walk test

BACKGROUND Changes arising from the aging process, particularly changes in body composition, contribute to the functional decline of the elderly. OBJECTIVE To compare the body composition and muscle strength, mobility and quality in active elderly women according to the distance walked during the 6-minute walk test (6MWT). METHOD The study included 77 active elderly women aged 65 to 80 years, who were divided into tertiles (A, B and C) according to the distance covered in the 6MWT. We performed anthropometric and clinical evaluations. Body composition was determined by dual energy X-ray absorptiometry (DXA). Handgrip strength (HGS) was measured with a portable dynamometer (Saehan), and knee extension strength (KES) was measured with the one repetition maximum test (1-RM). Functional mobility was assessed by the Timed Up and Go (TUG) test, and body balance was assessed by the Berg Balance Scale (BBS). Muscle quality was defined by the ratio between muscle strength (kgf) and muscle mass (kg). RESULTS The group that walked the shortest distance in the 6MWT had a higher BMI (A=30.8±7.0, B=27.2±4.2 and C=25.9±3.5 kg/m2), greater amount of fat mass (A=31.3±10.7, B=25.9±6.7 and C=23.81±6.46 kg) lower HGS (A=21.8±5.1, B=22.1±3.5 and C=25.5±5.1 kgf), lower knee extension strength (A=30.6±10.9, B=40.4±12.5 and C=47.2±10.1 kgf), lower arm muscle quality (A=10.1±3.7, B=11.6±2 and C=12.7±2.2 kg) and lower leg muscle quality (A=1.78±1, B=2.84±0.98 and C=3.31±0.77 kg). There was no significant difference between muscle mass (p=0.25) and lean mass (p=0.26). CONCLUSION Body fat has a negative influence on functional performance, even among active elderly women.

Quedas e qualidade de vida de idosos com catarata

Objetivo: Investigar a associacao entre quedas e qualidade de vida em idosos com catarata. Metodos: Tratou-se de estudo observacional com delineamento transversal, realizado no Distrito Federal, Brasil, com uma amostra de 38 idosos comunitarios divididos em dois grupos: idosos caidores (n=18) e idosos nao caidores (n=20). Avaliou-se por meio do instrumento National Eye Institute - Visual Function Questionnaire 25 (NEI-VFQ 25) a saude geral dos individuos da amostra, assim como a qualidade de vida relacionada a saude visual. A caracterizacao da amostra foi realizada por meio da analise descritiva a fim de avaliar a associacao entre quedas e demais variaveis, utilizou-se o teste nao parametrico de Mann-Whitney (p<0,05). Resultados: A faixa etaria ≥ 70 anos prevaleceu entre os participantes da pesquisa (63,16%). Dentre os idosos que fizeram parte deste estudo, 36 (94,74%) relataram ter algum problema para enxergar. Idosos caidores apresentaram escore geral mais baixo, quando comparados aos nao caidores (p=0,0159), apresentaram tambem maior dificuldade em realizar atividades para perto (p=0,0299) e para longe (p=0,0104), pior saude mental (p=0,0001) e nivel mais elevado de dependencia (p=0,0008). Conclusao: As quedas interferem negativamente na qualidade de vida de idosos com catarata, tornando as acoes para prevencao de quedas e o tratamento e/ou correcao do deficit visual importantes para evitar prejuizos futuros.

Concordância de diferentes critérios de sarcopenia em idosas comunitárias

The frequency and concordance between different sarcopenia criteria was assessed in community women of age. This is a cross-sectional study with 64 women of age, in which muscle mass was determined by bioelectrical impedance analysis (BIA) and skeletal muscle index calculation, muscle strength was determined with a handgrip strength dynamometer, functional capacity was determined with the tests Timed Up and Go (TUG) and Sit to Stand test (STS). This older population was classified in sarcopenic, pre-sarcopenic, moderate sarcopenic and severe sarcopenic by using different sarcopenia criteria. The data were analyzed with use of Chi-square test and Kappa statistics. The results obtained demonstrated that 37.5% of the women suffered of low muscle mass, 34.4% of muscle weakness, 3.1% of functional impairment to stand and walk and 25.9% to sit and raise from the chair. Considering only muscle mass, 37.5% of the sample was classified as sarcopenic (moderate or severe) and, considering the criteria of the European Working Groups on Sarcopenia in Older People, 15.6% obtained this classification when assessing functional capacity with TUG and 22.4% with STS. Concordance between sarcopenia definitions ranged from moderate to excellent (p<0.001). Among women with muscle mass integrity (n=40), 30% showed low handgrip strength, 2.5% showed impairment in TUG and 25.7% in STS. It was concluded that the women presented high frequency of sarcopenia, regardless of the criteria used. Moderate to excellent concordance was observed between the sarcopenia criteria investigated. Identification of older people with muscle mass integrity coexisting with muscle weakness and functional impairment reinforces the importance of the evaluation of the three parameters in the clinical scientific setting.Study performed in the Laboratory for Functional Human Performance at Universidade de Brasília – Brasília (DF), Brazil. 1Physical Therapist by Universidade de Brasília (UnB) – Brasília (DF), Brazil. 2Physical Therapy Committee of Universidade de Brasilia (UnB) – Brasília (DF), Brazil. 3Post-Graduate program in Gerontology of Universidade Católica de Brasília (UCB) – Brasília (DF), Brazil. 4Post-Graduate program in Rehabilitation Sciences of Universidade de Brasilia (UnB) – Brasília (DF), Brazil.

Concordancia de distintos criterios de sarcopenia en ancianas comunitarias

The frequency and concordance between different sarcopenia criteria was assessed in community women of age. This is a cross-sectional study with 64 women of age, in which muscle mass was determined by bioelectrical impedance analysis (BIA) and skeletal muscle index calculation, muscle strength was determined with a handgrip strength dynamometer, functional capacity was determined with the tests Timed Up and Go (TUG) and Sit to Stand test (STS). This older population was classified in sarcopenic, pre-sarcopenic, moderate sarcopenic and severe sarcopenic by using different sarcopenia criteria. The data were analyzed with use of Chi-square test and Kappa statistics. The results obtained demonstrated that 37.5% of the women suffered of low muscle mass, 34.4% of muscle weakness, 3.1% of functional impairment to stand and walk and 25.9% to sit and raise from the chair. Considering only muscle mass, 37.5% of the sample was classified as sarcopenic (moderate or severe) and, considering the criteria of the European Working Groups on Sarcopenia in Older People, 15.6% obtained this classification when assessing functional capacity with TUG and 22.4% with STS. Concordance between sarcopenia definitions ranged from moderate to excellent (p<0.001). Among women with muscle mass integrity (n=40), 30% showed low handgrip strength, 2.5% showed impairment in TUG and 25.7% in STS. It was concluded that the women presented high frequency of sarcopenia, regardless of the criteria used. Moderate to excellent concordance was observed between the sarcopenia criteria investigated. Identification of older people with muscle mass integrity coexisting with muscle weakness and functional impairment reinforces the importance of the evaluation of the three parameters in the clinical scientific setting.Study performed in the Laboratory for Functional Human Performance at Universidade de Brasília – Brasília (DF), Brazil. 1Physical Therapist by Universidade de Brasília (UnB) – Brasília (DF), Brazil. 2Physical Therapy Committee of Universidade de Brasilia (UnB) – Brasília (DF), Brazil. 3Post-Graduate program in Gerontology of Universidade Católica de Brasília (UCB) – Brasília (DF), Brazil. 4Post-Graduate program in Rehabilitation Sciences of Universidade de Brasilia (UnB) – Brasília (DF), Brazil.

Concordance of different criteria for sarcopenia in community women of age

The frequency and concordance between different sarcopenia criteria was assessed in community women of age. This is a cross-sectional study with 64 women of age, in which muscle mass was determined by bioelectrical impedance analysis (BIA) and skeletal muscle index calculation, muscle strength was determined with a handgrip strength dynamometer, functional capacity was determined with the tests Timed Up and Go (TUG) and Sit to Stand test (STS). This older population was classified in sarcopenic, pre-sarcopenic, moderate sarcopenic and severe sarcopenic by using different sarcopenia criteria. The data were analyzed with use of Chi-square test and Kappa statistics. The results obtained demonstrated that 37.5% of the women suffered of low muscle mass, 34.4% of muscle weakness, 3.1% of functional impairment to stand and walk and 25.9% to sit and raise from the chair. Considering only muscle mass, 37.5% of the sample was classified as sarcopenic (moderate or severe) and, considering the criteria of the European Working Groups on Sarcopenia in Older People, 15.6% obtained this classification when assessing functional capacity with TUG and 22.4% with STS. Concordance between sarcopenia definitions ranged from moderate to excellent (p<0.001). Among women with muscle mass integrity (n=40), 30% showed low handgrip strength, 2.5% showed impairment in TUG and 25.7% in STS. It was concluded that the women presented high frequency of sarcopenia, regardless of the criteria used. Moderate to excellent concordance was observed between the sarcopenia criteria investigated. Identification of older people with muscle mass integrity coexisting with muscle weakness and functional impairment reinforces the importance of the evaluation of the three parameters in the clinical scientific setting.Study performed in the Laboratory for Functional Human Performance at Universidade de Brasília – Brasília (DF), Brazil. 1Physical Therapist by Universidade de Brasília (UnB) – Brasília (DF), Brazil. 2Physical Therapy Committee of Universidade de Brasilia (UnB) – Brasília (DF), Brazil. 3Post-Graduate program in Gerontology of Universidade Católica de Brasília (UCB) – Brasília (DF), Brazil. 4Post-Graduate program in Rehabilitation Sciences of Universidade de Brasilia (UnB) – Brasília (DF), Brazil.

Association between religiosity and functional capacity in older adults: a systematic review

Objective: To verify the association between religiosity and functional capacity in the elderly. Method: a systematic review of literature in the SciELO, Lilacs, MEDLINE/ PubMed and the portal of CAPES Journals databases was performed. The descriptors were selected through the list of Descriptors in Health Sciences (Decs) and Medical Subject Headings (Mesh). Original articles in Portuguese and English, published between 2007 Palavras-chave: Idoso. Religião. Espiritualidade. Atividades Diárias. http://dx.doi.org/10.1590/1981-22562017020.170088

Composição corporal de jovens e idosas eutróficas e com sobrepeso avaliada pelo método óxido de deutério e diferentes equações antropométricas

Objective: To evaluate the body fat percentage and body lean and fat mass of eutrophic young women and eutrophic and overweight/obese elderly women using anthropometry (generalized and specific equations) and deuterium oxide and to define the concordance coefficient between the equations and the deuterium oxide method (reference).Methods: Forty eight volunteers (15 eutrophic young women, 18 eutrophic elderly women, and 15 overweight/obese elderly women), aged between 18 and 75 years, participated in this study. Body weight was measured using a digital scale, and height was measured using a stadiometer with a vertical backboard. Body composition was assessed using anthropometric equations and deuterium oxide (2H2O). Data were analyzed using descriptive statistics, Students t test, Lins concordance coefficient, and Bland-Altman plot.Results: The mean age and body mass index were, respectively: 25.6±3.7 years and 20.9±2.2 kg/m2 for the eutrophic young women; 69.1±3.6 years and 23.8±1.8 kg/m2 for the eutrophic elderly women; and 69.6±3.0 years and 32.6±2.6 kg/m2 for the overweight/obese elderly women. The best concordance coefficients between the anthropometric equations and deuterium oxide for body fat were: eutrophic young women, Deuterium versus Sloan - 0.70; eutrophic elderly women, Deuterium versus Jackson - 0.89; and overweight/obese elderly women, Deuterium versus Deurenberg - 0.77.Conclusion: The equations that showed the best concordance with deuterium oxide were: Sloan for eutrophic young women; Jackson and Durnin & Wormersley for eutrophic elderly women; and Deurenberg, and Visser for overweight/obese elderly women.

Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy

Objective : To assess muscle mass, risk of falls and fear of falling in elderly adults with diabetic neuropathy (DNP). Methods : 50 elderly patients with diabetes mellitus (DM) and diabetic neuropathy (NPD) participated in this study. Risk of falling was assessed using the Berg Balance Scale (BBS). Fear of falling was assessed by means of the Falls Efficacy Scale-International (FES-I). Muscle mass was assessed by tetrapolar bioimpedance analysis (BIA) and Janssens equation. Subjects were divided into two groups: one with a history of falls in the six months before study enrollment (G1) and the other without history of falls (G2). Results : There were statistically significant differences between G1 and G2 regarding lean body mass (p < 0.05), risk of falls as measured by the BBS (p < 0.01), and fear of falling as measured by the FES-I (p < 0.01). In addition, there was a significant correlation between the BBS and BIA (r = 0.45 and p < 0.01), showing that the greater the lean body mass, the lower the risk of falling. Conclusions : We found an association between lean mass, risk of falls and fear of falling in elderly adults with DNP and a history of falls from own height.

Estabilidad postural, riesgo de caídas y miedo de caer en ancianos con neuropatía diabética que realizan ejercicios terapéuticos

Este estudo objetivou analisar a estabilidade postural, o risco de quedas e o medo de cair em idosos com neuropatia diabetica (NPD) que realizam exercicios terapeuticos. Realizou-se uma triagem para rastreio de idosos com NPD por meio dos instrumentos Escore de Sintomas Neuropaticos (ESN) e Escore de Comprometimento Neuropatico (ECN). Os 50 pacientes selecionados para participar do estudo foram divididos em dois grupos: 24 do G1 (os que estavam realizando exercicios terapeuticos) e 26 do G2 (o grupo controle). Para avaliar a estabilidade postural, risco de quedas e o medo de cair entre os grupos foram utilizadas a plataforma de pressao, a Escala de Equilibrio de Berg (EEB) e a Escala de Eficacia de Quedas (FES-I). Nao foram observadas diferencas significativas no resultado das escalas EEB (p=0,16) e FES-I (p=0,15) entre o G1 e o G2; pela plataforma de pressao, foram encontradas diferencas entre G1 e G2 nos parâmetros comprimento da trajetoria (CT) e estabilidade medio-lateral (ML), ambos com os olhos fechados (OF). Os idosos com NPD que realizam exercicios terapeuticos apresentam melhor estabilidade ML e no CT com OF que idosos sedentarios; contudo, nao foram observadas associacoes com o exercicio terapeutico, risco de quedas e medo de cair.