Indicators of sarcopenia and their relation to intrinsic and extrinsic factors relating to falls among active elderly women

12 weeks of resistance training with progressive intensity improves the diagnostic parameters of sarcopenia in individuals of advanced age

OBJECTIVE

The objective of this study was to evaluate the effects of 12 weeks of resistance training (RT) with progressive intensity on factors associated with sarcopenia in older individuals.

METHODS

A cross-sectional study was conducted with 74 participants (64.27 ± 7.06-y-old) who were divided into a control group (n = 37) and an intervention group (n = 37). The intervention group underwent 12 weeks of RT three times a week, with an initial training of 60% and final training of 85% of one-repetition maximum (1RM). Both groups were evaluated before and after the 12-week training period to assess improvements in strength and physical performance.

RESULTS

The intervention group showed an increase in physical performance, as evidenced by a reduction in the time to perform the Timed Up and Go (TUG) test (p < 0.01) and the Five Times Sit to Stand Test (p < 0.01). Furthermore, the RT proved to be efficient for increasing hand grip and overall muscular strength, as confirmed through the 1RM test. However, the muscle mass index (MMI) and walking speed did not show any significant alterations in both groups.

CONCLUSIONS

In conclusion, 12 weeks of RT with progressive intensity has a positive effect on the diagnostic parameters of sarcopenia, leading to improvements in physical performance and muscular strength while maintaining the MMI.

Factors that cause women with osteoporosis to fall

Objective

To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis.

Subjects and methods

A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale-International (FES-I) and investigated the extrinsic factors for falls.

Results

We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n=71, 49.5%), a faller group (FG; 1 fall, n=42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n=31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P<.005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P=.015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P=.028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P<.001).

Conclusion

Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review

BACKGROUND

Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia.

OBJECTIVES

this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia.

METHODS

In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages.

RESULTS

19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world.

CONCLUSION

It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.

Reliability of HOME FAST BRAZIL-Self-Reported Version for Community-Dwelling Older Adults

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.

Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used.

Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.

Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

Cognitive and behavioral factors associated to probable sarcopenia in community-dwelling older adults

Background: Sarcopenia has a high prevalence in older adults and is associated with chronic aggravations to health, so therefore it is important to identify older adults who are affected by sarcopenia in order to establish preventative strategies or early interventions.Objective: To estimate the prevalence of probable sarcopenia and verify its association with cognitive impairment, fear of falling, depressive symptoms and health self-perception in community-dwelling older adults.Methods: A cross-sectional study with simple random sampling including 306 older adults of both genders. The outcome variable was probable sarcopenia evaluated by the Five times sit-to-stand test (5XSST) considering probable sarcopenia when the measured time was > 15 seconds, following the recommendation of the European Working Group on Sarcopenia in Older People. The predictor variables were cognitive impairment, fear of falling, depressive symptoms and self-perception of health. Multivariate Logistic Regression was performed to verify associations between the variables.Results: The prevalence of probable sarcopenia was 50.00%. The older adults had significantly higher chances of presenting probable sarcopenia when displaying cognitive impairment (OR 2.49; 95%CI 1.46-4.24), fear of falls (OR 4.23; 95%CI 2.51-7.12), depressive symptoms (OR 2.20; 95%CI 1.32-3.67), poor (OR 2.48; 95%CI 1.19-5.16) and fair self-perception of health (OR 2.11; 95%CI 1.22-3.63) when compared to those who did not have the same conditions.Conclusion: The prevalence of probable sarcopenia in this study was 50.00%, and was associated with the presence of depressive symptoms, cognitive impairment, fear of falls and negative self-perception of health.

The HOME FAST BRAZIL self-report version: translation and transcultural adaptation into Brazilian Portuguese

OBJECTIVE

To translate and cross-culturally adapt the Home Falls and Accidents Screening Tool Self-report into Brazilian Portuguese and to correlate with the history of falls.

METHODS

The translation and transcultural adaptation process followed international parameters. The Home Falls and Accidents Screening Tool Brazil Self-report, the Mini-Mental State Examination and the history of falls were applied to 10 elderly in the pre-test and to 41 in the final. Demographic and anthropometric data were also evaluated. Spearman correlation coefficient was performed.

RESULTS

The participants considered the questionnaire easy to understand and did not report any doubts to answer the final version. There was significant correlation between: Home Falls and Accidents Screening Tool Brazil Self-report score and number of falls (ρ = 0.31, p = 0.02) and the lighting and bathroom domains with presence of falls at home (ρ = 0.44, p = 0.00 and ρ = 0.33, p = 0.02, respectively). The questionnaire indicated fall's risk scoring, 10(±2).

CONCLUSION

The Home Falls and Accidents Screening Tool Brazil Self-report showed to be comprehensible and feasible tool for self-assessment of domiciliary falls risk in Brazilian older people. The scores indicated fall's risk and were associated with the history of falls.

Effects of Dance Exergaming on Depressive Symptoms, Fear of Falling, and Musculoskeletal Function in Fallers and Nonfallers Community-Dwelling Older Women

The aim of this study was to evaluate the effects of a pop dance exergaming protocol on fall risk factors-depressive symptoms, fear of falling, and musculoskeletal function-in community-dwelling older female fallers and nonfallers. There were 47 community-dwelling older women assigned to the intervention group (IG) [fallers (n = 10, 69.8 ± 4.3 years); nonfallers (n = 12, 68.9 ± 3.3 years)] and the control group (CG) [fallers (n = 12, 73.6 ± 5.4 years); nonfallers (n = 13, 68.7 ± 4.8 years)]. The CG maintained their lifestyle and the IG performed a videogame dance training three times per week for 12 weeks. The Dance Central game for Xbox 360® and Kinect motion sensor were used. The primary outcomes were geriatric depressive symptoms, fear of falling, and concentric and eccentric isokinetic peak torque (PT) of quadriceps and hamstrings. Secondary outcomes included cross-sectional area of quadriceps and hamstring muscles, functionality (Timed Up and Go test, gait speed, the Five Times Sit-to-Stand test), and a fall circumstances and outcomes recording. The depressive symptoms decreased in the Intervention Fallers Group. The eccentric hamstrings PT at 180°/s increased in the Intervention Nonfallers Group. There were no significant differences between groups for the other variables analyzed. The training attendance was 83% for the Intervention Fallers Group and 88% for the Intervention Nonfallers Group. Dance exergaming can be indicated to decrease depressive symptoms in fallers and increase the PT in nonfallers among community-dwelling older women.