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Objetivo: Verificar a associação entre indicadores espirométricos e a incidência da síndrome de fragilidade em pessoas idosas. Métodos: Trata-se de um estudo com delineamento longitudinal realizado em 2014-2019, com uma amostra de estudo de 104 pessoas idosas. A variável dependente foi a síndrome de fragilidade, avaliada por meio do fenótipo de Fried et al. e as variáveis independentes foram os indicadores espirométricos, sendo eles a Capacidade Vital Forçada (CVF), Pico de Fluxo Expiratório (PFE), Volume Expiratório Forçado no primeiro segundo (VEF1), relação VEF1/CVF e o Fluxo Expiratório Forçado 25%-75% (FEF25-75%). Resultados: A incidência de pessoas idosas frágeis foi de 16,3% em ambos os sexos, sendo que o sexo masculino apresentou melhores indicadores de função pulmonar que as mulheres. Apesar disso, observamos que não houve associação entre a síndrome de fragilidade e os indicadores espirométricos (p>0,05). Conclusão: Os indicadores espirométricos não são preditores de fragilidade em pessoas idosas residentes na comunidade, após cinco anos de seguimento.

Objective: To verify the association between spirometric indicators and the incidence of frailty syndrome in elderly people. Methods: This is a study with a longitudinal design carried out in 2014-2019, with a study sample of 104 elderly people. The dependent variable was the frailty syndrome, assessed using the phenotype of Fried et al. and the independent variables were the spirometric indicators, namely Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio and Forced Expiratory Flow 25%-75 % (FEF25-75%). Results: The incidence of frail elderly people was 16.3% in both genders, with males presenting better lung function indicators than females. Despite this, we observed that there was no association between the frailty syndrome and the spirometric indicators (p>0.05). Conclusion: Spirometric indicators are not predictors of frailty in community-dwelling elderly people after five years of follow-up.

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OBJECTIVE: To evaluate and compare the effects of conventional proprioceptive training and games with motion monitoring on plantar tactile sensitivity in older women. METHODS: A randomized controlled clinical trial, with 50 older women randomized into three groups: conventional proprioception (n = 17), games with motion monitoring (n = 16), and the control (n = 17). They underwent 24 intervention sessions, three times a week, for eight weeks. The conventional proprioception group performed exercises involving gait, balance, and proprioception. The games performed by the motion monitoring group included exercises using the Xbox Kinect One video game from Microsoft®. The evaluation of tactile pressure sensitivity was performed using Semmes-Weinstein monofilaments. Intragroup comparisons between the two paired samples were performed using paired Student's t-test or Wilcoxon test. Intergroup comparisons between the three independent samples were performed using the Kruskal-Wallis test and Dunn's post hoc test, with p ≤ 0.05. RESULTS: The older women submitted to conventional games with motion monitoring training and showed improvement in plantar tactile sensitivity in the right and left feet. When comparing the intergroup results, the two training modalities obtained an improvement in the plantar tactile sensitivity of the older women when compared to the control group. CONCLUSIONS: We conclude that both training modalities may favor the improvement of plantar tactile sensitivity in older women, with no significant differences between conventional and virtual training.

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Resumo O objetivo deste artigo é investigar a associação entre a Pressão Inspiratória Máxima (PImáx) e Pressão Expiratória Máxima (PEmáx) com a incidência da síndrome de fragilidade (SF), além de testar a capacidade preditiva da PImáx e PEmáx em discriminar a SF em idosos, de acordo com o sexo. Estudo longitudinal com cinco anos de seguimento (2014-2019), realizado com 104 idosos cadastrados na Estratégia Saúde da Família de um município da Bahia. A incidência da síndrome de fragilidade foi diagnosticada de acordo os critérios propostos por Fried et al., utilizando dados de 2019, após cinco anos de seguimento. A PImáx e PEmáx foram avaliadas conforme recomendações da Sociedade Brasileira de Pneumologia e Tisiologia em 2014 (linha de base). A incidência total da SF foi de 16,3% (IC95%: 9,2-23,6), sendo 13,6% (IC95%: 4,56-22,55) no sexo feminino e 20,0% (IC95%: 7,85-32,15) no sexo masculino. Os valores médios da PImáx e PEmáx foram, respectivamente, 60,8±21,2 cmH2O e 76,7±23,1 cmH2O no sexo feminino, e 79,5±27,0 cmH2Oe 114,7±29,8 cmH2O no sexo masculino. A SF esteve associada à PEmáx em idosos do sexo masculino (RR ajustado: 0,96; IC95%: 0,95-0,98; p-valor: 0,002), indicando que o aumento de 1 cmH2O da PEmáx reduz em 4% o risco de desenvolver a síndrome de fragilidade.

Abstract This article aims to investigate the association between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with the incidence of frailty syndrome (FS), in addition to testing the predictive ability of MIP and MEP to discriminate FS in elderly adults, according to sex. It is a longitudinal study with a five-year follow-up period (2014-2019), carried out with 104 elderly adults registered in the Family Health Strategy of a municipality in Bahia. The incidence of frailty syndrome was diagnosed according to criteria proposed by Fried et al., using data from 2019, after a five-year follow-up. The MIP and MEP were evaluated according to the recommendations of the Brazilian Society of Pulmonology and Phthisiology data in 2014 (baseline data). The total incidence of frailty syndrome was 16.3% (95%CI: 9.2-23.6), with 13.6% (95%CI: 4.56-22.55) in women and 20% (95%CI: 7.85-32.15) in men. The mean values of MIP and MEP were, respectively, 60,8±21,2 cmH2O and 76,7±23,1 cmH2O in women, and 79,5±27,0 cmH2O and 114,7±29,8 cmH2O in men. The frailty syndrome was associated with MEP in elderly adult men (adjusted RR: 0.96; 95%CI: 0.95-0.98; P-value: 0.002), indicating that the increase of 1cmH2O in MEP reduces by 4% the risk of developing the syndrome.

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This article aims to investigate the association between maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with the incidence of frailty syndrome (FS), in addition to testing the predictive ability of MIP and MEP to discriminate FS in elderly adults, according to sex. It is a longitudinal study with a five-year follow-up period (2014-2019), carried out with 104 elderly adults registered in the Family Health Strategy of a municipality in Bahia. The incidence of frailty syndrome was diagnosed according to criteria proposed by Fried et al., using data from 2019, after a five-year follow-up. The MIP and MEP were evaluated according to the recommendations of the Brazilian Society of Pulmonology and Phthisiology data in 2014 (baseline data). The total incidence of frailty syndrome was 16.3% (95%CI: 9.2-23.6), with 13.6% (95%CI: 4.56-22.55) in women and 20% (95%CI: 7.85-32.15) in men. The mean values of MIP and MEP were, respectively, 60,8±21,2 cmH2O and 76,7±23,1 cmH2O in women, and 79,5±27,0 cmH2O and 114,7±29,8 cmH2O in men. The frailty syndrome was associated with MEP in elderly adult men (adjusted RR: 0.96; 95%CI: 0.95-0.98; P-value: 0.002), indicating that the increase of 1cmH2O in MEP reduces by 4% the risk of developing the syndrome.

O objetivo deste artigo é investigar a associação entre a Pressão Inspiratória Máxima (PImáx) e Pressão Expiratória Máxima (PEmáx) com a incidência da síndrome de fragilidade (SF), além de testar a capacidade preditiva da PImáx e PEmáx em discriminar a SF em idosos, de acordo com o sexo. Estudo longitudinal com cinco anos de seguimento (2014-2019), realizado com 104 idosos cadastrados na Estratégia Saúde da Família de um município da Bahia. A incidência da síndrome de fragilidade foi diagnosticada de acordo os critérios propostos por Fried et al., utilizando dados de 2019, após cinco anos de seguimento. A PImáx e PEmáx foram avaliadas conforme recomendações da Sociedade Brasileira de Pneumologia e Tisiologia em 2014 (linha de base). A incidência total da SF foi de 16,3% (IC95%: 9,2-23,6), sendo 13,6% (IC95%: 4,56-22,55) no sexo feminino e 20,0% (IC95%: 7,85-32,15) no sexo masculino. Os valores médios da PImáx e PEmáx foram, respectivamente, 60,8±21,2 cmH2O e 76,7±23,1 cmH2O no sexo feminino, e 79,5±27,0 cmH2Oe 114,7±29,8 cmH2O no sexo masculino. A SF esteve associada à PEmáx em idosos do sexo masculino (RR ajustado: 0,96; IC95%: 0,95-0,98; p-valor: 0,002), indicando que o aumento de 1 cmH2O da PEmáx reduz em 4% o risco de desenvolver a síndrome de fragilidade.

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OBJECTIVE: To compare maximum respiratory pressures and spirometric parameters among elderly individuals classified as having no sarcopenia, probable sarcopenia, and confirmed sarcopenia, and to test the ability of these variables to discriminate sarcopenia in a community-dwelling elderly population. METHODS: This was a cross-sectional study involving 221 elderly (≥ 60 years of age) individuals of both sexes. Sarcopenia was diagnosed in accordance with the new consensus of the European Working Group on Sarcopenia in Older People. Maximum respiratory pressures and spirometry parameters were assessed. RESULTS: The prevalences of probable sarcopenia and confirmed sarcopenia were 20.4% and 4.1%, respectively. Regardless of the sex, those with confirmed sarcopenia had significantly lower MEP than those with no sarcopenia and probable sarcopenia, whereas only males with confirmed sarcopenia presented with significantly lower MIP than did the other individuals. There was an inverse association of MIP and MEP with sarcopenia, indicating that the decrease by 1 cmH2O in these parameters increases the chance of sarcopenia by 8% and 7%, respectively. Spirometric parameters were not associated with sarcopenia. Cutoff points for MIP and MEP, respectively, were ≤ 46 cmH2O and ≤ 50 cmH2O for elderly women, whereas they were ≤ 63 cmH2O and ≤ 92 cmH2O for elderly men, and both were identified as predictors of sarcopenia (area under the ROC curve > 0.70). CONCLUSIONS: Sarcopenia was associated with lower maximum respiratory pressures, but not with spirometric parameters. Maximum respiratory pressures can be used as markers of sarcopenia in a community-dwelling elderly population regardless of the sex.

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Abstract Aim: This study aimed to identify the prevalence and factors associated with dynapenia in older women, considering different cutoff points as diagnostic criteria. Methods: This epidemiological study was conducted with 205 older women (72.7 ± 7.1 years). Dynapenia was diagnosed using the handgrip strength test (HGS) using two cutoff points (< 16 or < 20 kgf). Socio-demographic, behavioral, and health status information was obtained from a specific form; nutritional status was assessed by body mass index, and the International Physical Activity Questionnaire identified the level of physical activity. Results: The prevalence of dynapenia was 14.1% (HGS < 16 kgf) and 46.3% (HGS < 20 kgf) (p < 0.001). It was also observed that older women with family income ≤ 1 minimum wage and those with low weight presented, respectively, 2.22 (95%CI: 1.12-4.39) and 4.72 (95%CI: 1.64-13.58) times higher probability of dynapenia identified by HGS < 16 kgf. Moreover, for the cutoff point < 20 kgf, the probability of dynapenia was higher in women aged ≥ 80 years (PR:1.91; 95%CI: 1.23-2.95), in insufficiently active women (PR: 1.34; 95%CI: 1.01-2.57), among those with low weight (PR: 1.61; 95%CI: 1.01-2.57), and in those who reported falls (PR:1.42; 95%CI: 1.04-1.96). Conclusion: Therefore, it is concluded that there is a difference between the prevalence and factors associated with dynapenia when different cutoff points are adopted.

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ABSTRACT Objective: To compare maximum respiratory pressures and spirometric parameters among elderly individuals classified as having no sarcopenia, probable sarcopenia, and confirmed sarcopenia, and to test the ability of these variables to discriminate sarcopenia in a community-dwelling elderly population. Methods: This was a cross-sectional study involving 221 elderly (≥ 60 years of age) individuals of both sexes. Sarcopenia was diagnosed in accordance with the new consensus of the European Working Group on Sarcopenia in Older People. Maximum respiratory pressures and spirometry parameters were assessed. Results: The prevalences of probable sarcopenia and confirmed sarcopenia were 20.4% and 4.1%, respectively. Regardless of the sex, those with confirmed sarcopenia had significantly lower MEP than those with no sarcopenia and probable sarcopenia, whereas only males with confirmed sarcopenia presented with significantly lower MIP than did the other individuals. There was an inverse association of MIP and MEP with sarcopenia, indicating that the decrease by 1 cmH2O in these parameters increases the chance of sarcopenia by 8% and 7%, respectively. Spirometric parameters were not associated with sarcopenia. Cutoff points for MIP and MEP, respectively, were ≤ 46 cmH2O and ≤ 50 cmH2O for elderly women, whereas they were ≤ 63 cmH2O and ≤ 92 cmH2O for elderly men, and both were identified as predictors of sarcopenia (area under the ROC curve > 0.70). Conclusions: Sarcopenia was associated with lower maximum respiratory pressures, but not with spirometric parameters. Maximum respiratory pressures can be used as markers of sarcopenia in a community-dwelling elderly population regardless of the sex.

RESUMO Objetivo: Comparar as pressões respiratórias máximas e parâmetros espirométricos entre idosos classificados como sem sarcopenia, sarcopenia provável e sarcopenia confirmada e testar a capacidade dessas variáveis de discriminar sarcopenia em idosos residentes em comunidade. Métodos: Estudo transversal envolvendo 221 idosos (≥ 60 anos) de ambos os sexos. Sarcopenia foi diagnosticada de acordo com o novo consenso do Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas. As pressões respiratórias máximas e parâmetros espirométricos foram avaliados. Resultados: As prevalências de sarcopenia provável e sarcopenia confirmada foram de 20,4% e 4,1%, respectivamente. Independentemente do sexo, aqueles com sarcopenia confirmada apresentaram PEmáx significativamente menor do que aqueles sem sarcopenia e provável sarcopenia, enquanto apenas os homens com sarcopenia confirmada apresentaram PImáx significativamente menor do que os outros indivíduos. Houve uma associação inversa de PImáx e PEmáx com sarcopenia, indicando que a diminuição de 1 cmH2O nesses parâmetros aumenta a chance de sarcopenia em 8% e 7%, respectivamente. Os parâmetros espirométricos não foram associados à sarcopenia. Os pontos de corte para PImáx e PEmáx, respectivamente, foram ≤ 46 cmH2O e ≤ 50 cmH2O para mulheres idosas, enquanto foram ≤ 63 cmH2O e ≤ 92 cmH2O para homens idosos, e ambas foram identificadas como preditores de sarcopenia (ASC ROC > 0,70). Conclusões: A sarcopenia associou-se a pressões respiratórias máximas mais baixas, mas não a parâmetros espirométricos. As pressões respiratórias máximas podem ser usadas como marcadores de sarcopenia em idosos residentes em comunidade, independentemente do sexo.

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Abstract Aim: Anthropometry represents an alternative to the evaluation of nutritional status and screening of events related to muscle fitness. Therefore, this study aimed to compare anthropometric indicators of postmenopausal women with and without dynapenia and to identify the predictive capacity of these indicators to screen the respective outcome in this population. Methods: Cross-sectional epidemiological study, conducted with postmenopausal women. Dynapenia was diagnosed by handgrip strength < 20 kgf. Arm (AC), abdominal (AbC), hip (HC) and calf circumferences (CC), triceps, biceps, subscapular, supraspinatus and thigh skinfolds were analyzed. Body Mass Index, Conicity Index (CI), Body Adiposity Index (BAI), Waist to Hip and Waist to Height Ratio (WHtR), Corrected Arm Muscle Area (CAMA) and Arm Muscle Circumference (AMC) were calculated. Results: A total of 273 women participated in the study. The BAI, WHtR, and CI did not present significant differences between the groups. For the other indicators, the dynapenic group obtained significantly lower values compared to the non-dynapenic. AC was the indicator with the highest sensitivity to screen for postmenopausal dynapenia (79.8%). While CAMA and AMC were the indicators with the best specificity (86.2%). However, CC showed the best balance between sensitivity (67.5%) and specificity (63.0%). Conclusion: The indicators AC, CAMA, and/or the AMC can be used together, or CC alone, to predict postmenopausal women with dynapenia. Therefore, these indicators can be used as important epidemiological tools to improve women's health surveillance actions.

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O objetivo desta revisão sistemática foi analisar o efeito do treinamento combinado na pressão arterial de idosos hipertensos. As buscas foram realizadas em novembro de 2021 nas bases de dados: National library of medicine, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scopus. Os critérios de inclusão foram: ensaios clínicos randomizados; população com idade ≥60 anos e com diagnóstico de hipertensão arterial; exercício combinado como intervenção; pressão arterial como um dos desfechos; publicados no idioma inglês e/ou português entre 2007 e 2021 e disponíveis em texto completo. Após as buscas, foram identificados 991 artigos científicos. Destes, 9 estudos foram selecionados por atenderam ao objetivo e aos critérios propostos. O tamanho das amostras variou de 20-115 participantes, com média de 48,7 ± 29,8. Todos os estudos foram conduzidos com idosos; 44,4% foram realizados com população somente do sexo feminino e 22,2% dos estudos com população do sexo masculino. No que se refere ao período de realização da intervenção, observou-se que o treinamento combinado foi executado desde uma única sessão até 16 semanas, numa frequência de três vezes por semana. Os estudos apontaram que após a realização do treinamento combinado, ocorreram reduções significativas nos valores de pressão arterial sistólica e diastólica. Apesar do treinamento combinado ter contribuído significativamente para reduzir os valores de pressão arterial, os resultados desta revisão sistemática devem ser interpretados com cautela, devido ao pequeno número de artigos inclusos e de suas respectivas limitações metodológicas. (AU)

The objective of this systematic review was to analyze the effect of combined training on blood pressure in hypertensive older adults. Searches were conducted in November 2021 in the databases: National library of medicine, Medical Literature Analysis and Retrieval System Online, Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences, and Scopus. Inclusion criteria were: randomized clinical trials; population aged ≥60 years and diagnosed with hypertension; combined exercise as intervention; blood pressure as one of the endpoints; published in English and/or Portuguese between 2007 and 2021 and available in full text. After the searches, 991 scientific articles were identified. From those, 9 studies were selected as they met the objective and the research criteria. Sample sizes ranged from 20-115 participants, with a mean of 48.7 ± 29.8. All studies were performed with seniors; 44.4% were conducted with a femaleonly population and 22.2% of the studies with a male-only population. Regarding the period of the intervention, it was observed that the combined training was executed from a single session up to 16 weeks, three times a week. The studies indicated that after the combined training, there were significant reductions in the values of systolic and diastolic blood pressure. Although combined training contributed significantly to reduce blood pressure values, the results of this systematic review should be interpreted with caution due to the small number of articles included and their respective methodological limitations. (AU)

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During aging, an increase in sedentary behaviour and a decrease in physical activity levels are observed. These factors may increase abdominal adiposity and triglyceride levels, which characterizes the hypertriglyceridemic waist (HW) phenotype, providing a high risk for cardiometabolic diseases. This study aimed to analyze the association between hypertriglyceridemic waist, physical activity level and sedentary behaviour in community-dwelling elderly. A population-based cross-sectional study was carried out, involving 316 elderlies (≥ 60 years) of both genders. The hypertriglyceridemic waist was diagnosed using high triglycerides (≥ 150 mg/dl) and increased waist circumference ≥ 88 and ≥ 102 cm values for women and men, respectively. The physical activity level and sedentary behaviour were evaluated using the IPAQ. The study included 173 women (54.7%) and 143 men (45.3%), with a mean age of 74.2 ± 9.8 years. The prevalence of HW was 27.1%, 47.7% insufficiently active and 24.1% high sedentary behaviour. The insufficiently active elderly (OR= 2.48; 95% CI: 1.31 - 4.71; p= 0.005) and with high sedentary behaviour (OR= 2.21; 95% CI: 1.04 - 4.32; p= 0.038) were associated positively with HW, indicating that elderly with insufficient physical activity levels and high sedentary behaviour showed themselves to approximately 2.5 and 2.2 times more likely to develop HW, respectively. Low physical activity level and high sedentary behaviour are associated with hypertriglyceridemic waist in community-dwelling elderly.(AU)

Durante o envelhecimento, observa-se aumento do comportamento sedentário e diminuições dos níveis de atividade física. Esses fatore podem aumentar a adiposidade abdominal e os níveis de triglicerídeos, o que caracteriza o fenótipo cintura hipertrigliceridêmica (CH), proporcionando um elevado risco para doenças cardiometabólicas. O objetivo deste estudo foi analisar a associação entre cintura hiper- trigliceridêmica, nível de atividade física e comportamento sedentário em idosos. Trata-se de um estudo epidemiológico, com delineamento transversal, de base populacional e domiciliar, realizado com 316 idosos (≥ 60 anos) de ambos os sexos. A cintura hipertrigliceridêmica foi definida a partir dos triglicérideos elevados (≥ 150 mg/dl) e circunferência da cintura alterada (≥ 88 cm para mulheres e ≥ 102 cm para homens). O nível de atividade física e o comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física (IPAQ). Participaram do estudo 173 mulheres (54,7%) e 143 homens (45,3%) com idade média de 74,2 ± 9,8 anos. A prevalência de CH foi 27,1%, 47,7% eram insuficientemente ativos e 24,1% tinham elevado comportamento sedentário. Os idosos insuficientemente ativos (OR= 2,48; IC95%:1,31 - 4,71; p= 0,005) e com elevado comportamento sedentário (OR= 2,21; IC95%:1,04 - 4,32; p= 0,038) foram positivamente associados à CH, indicando que os idosos com níveis de atividade física insuficientes e com elevado comportamento sedentário apresentaram, aproximadamente, 2,5 e 2,2 vezes mais chances de desenvolverem a CH, respectivamente. A inatividade física e o elevado comportamento sedentário estiveram associados à CH em idosos residentes em comunidade.(AU)

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