Prevalência e fatores associados à dinapenia em pessoas idosas da comunidade

Abstract

Introduction - Neuromuscular changes resulting from aging decrease the contractility potential of muscle fibers and impact physical strength. Age-related muscle weakness, known as dynapenia, is associated with the onset, progression and persistence of functional disability. Because of this, screening for this condition can help control health problems in the elderly, who are vulnerable to the impacts of physical decline during ageing. Dynapenia is linked to the risk of functional decline, frailty and physical disability in the elderly. Objective - To investigate the prevalence of dynapenia and the factors associated with it in elderly people in the community. Methods – This is an observational, analytical, cross-sectional epidemiological study. The participants' information came from the database of the study Frailty and functionality of elderly people in the community of a reference center in the city of Salvador, Bahia. The participants were male and female, aged 60 or over, and physically and cognitively able to perform the handgrip assessment. Sixty-three participants with neurological muscle diseases and severe cognitive impairment were excluded. Clinical, sociodemographic, cognitive status, functional capacity, basic and instrumental activities of daily living and fear of falling data were collected. Dynapenia was assessed using a hand-held dynamometer. Results – The sample consisted of 350 participants with a mean age of 75.43 years (SD=7.72). Among the participants, 307 (87.71%) were female, 154 (44%) were widowed, 214 (61.14%) had incomplete primary education, 220 (62.86%) used more than five medications and 74 (21.14%) had cognitive impairment. The prevalence of elderly people with dynapenia was 167 (47%) and the associated factors were the age group of 70 to 79 years (OR=2.13; 95% CI: 1.24-3.66), +80 years (OR=3.19; CI95%: 1.78-5.73), cognitive impairment (OR=1.82; CI95%: 1.08-3.07), report of fatigue (OR= 1.68; CI95%: 1.05-2.67), low level of physical activity (OR=3.03; CI95%: 1.94-4.73), gait speed (OR=3.18; CI95%: 2.04-4.90), risk of falls (OR=3.15; CI95%: 2.02-4.90), fear of falling (OR=2.51; CI95%: 1.51-4.15) and dependence for basic (OR=2.13; CI95%: 1.37-3.28) and instrumental activities of daily living (OR=1.79; CI95%: 1.14-2.82). Conclusion – This study identified a high prevalence of dynapenia in community-dwelling elderly individuals. Dynapenia was found to be associated with older age, self-reported cognitive impairment, fatigue, low levels of physical activity, reduced gait speed, risk of falling, fear of falling and dependence on basic and instrumental activities of daily living. These findings can support knowledge about aspects related to the health of elderly people in the community, favoring better geriatric health care.