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Obesidade abdominal, dinapenia e obesidade abdominal dinapênica como fatores associados à quedas em idosos residentes no Município de São Paulo - Estudo SABEMáximo, Roberta de Oliveira 15 February 2017 (has links)
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Previous issue date: 2017-02-15 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Objective: The aim of the present study was to investigate associations between abdominal obesity/dynapenia/dynapenic abdominal obesity and a single fall/recurrent falls as well as determine the effect size of such associations using two cutoff points for dynapenia. Methods: A cross-sectional study was conducted with 1.063 older adults pertaining to the third wave of the Saúde, Bem Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. Abdominal obesity was defined as a waist circumference of >102 cm for men and > 88 cm for women. The following were the cutoff points for dynapenia: grip strength < 30 kg for men and < 20 kg for women or < 26 kg for men and < 16 kg for women. Dynapenic abdominal obesity was defined by the combination of abdominal obesity and dynapenia. Regarding the outcome, the individuals were classified as non-fallers, single fallers or recurrent fallers. Socioeconomic, neuropsychiatric and environmental factors as well as living habits, polypharmacy, health status and functionality were the control variables in the multinomial regression models. Results: Adopting a cutoff point of 30/20, only one association was found: dynapenic abdominal obesity and a single fall (RRR = 2.37; 95% CI: 1.48-3.80). However, adopting a cutoff point of 26/16, dynapenic abdominal obesity (RRR = 1.93; 95% CI: 1.09-3.44), abdominal obesity (RRR = 1.65; 95% CI: 1.08-2.52) and dynapenia (RRR = 1.77; 95% CI: 1.01-3.13) were associated with a single fall, with a larger effect size of the association with dynapenic abdominal obesity than the other two conditions. Moreover, dynapenia defined using the 26/16 cutoff point was associated with recurrent falls (RRR = 2.39; 95% CI: 1.19-4.82). Conclusions: The cutoff point used to define dynapenia affects associations between abdominal obesity/dynapenia/dynapenic abdominal obesity and a single fall/recurring falls. A cutoff point of 26/16 is better for identifying such associations. / Objetivo: Investigar a associação de obesidade abdominal (OA), dinapenia e obesidade abdominal dinapênica (OA/D) com queda única e quedas recorrentes, assim como o tamanho do efeito de tais associações, adotando duas notas de cortes para dinapenia. Método: Estudo transversal com 1.063 idosos provenientes da terceira onda do Estudo SABE. OA foi definida como circunferência de cintura > 102 cm para homens e > 88 cm para mulheres. As notas de corte para dinapenia foram: força de preensão manual < 30 kg para homens e < 20 kg para mulheres ou < 26 kg para homens e < 16 kg para mulheres. OA/D foi definida pela associação de OA e dinapenia. Quanto ao desfecho, os idosos foram classificados como não caidores, caidores únicos ou recorrentes. Fatores socioeconômicos, neuropsiquiátricos, ambientais, hábitos de vida, polifarmácia, estado de saúde e funcionalidade foram variáveis de controle nos modelos de regressão multinomial. Resultados: Adotando a nota de corte 30/20, encontramos somente a associação entre OA/D e queda única (RRR = 2,37 IC 95% 1,48–3,80). Em contrapartida, adotando a nota de corte 26/16 tanto a OA/D (RRR = 1,93 IC 95% 1,09–3,44), quanto a OA (RRR = 1,65 IC 95% 1,08–2,52) e a dinapenia (RRR = 1,77 IC 95% 1,01–3,13) associaram-se à queda única, sendo o tamanho do efeito da associação maior com OA/D do que com as duas condições isoladas. Além disso, a dinapenia definida com o corte 26/16 associou-se com quedas recorrentes (RRR = 2,39 IC 95% 1,19–4,82). Conclusões: A nota de corte adotada para definir dinapenia modifica as associações de OA, dinapenia, OA/D com queda única e recorrente, sendo o corte 26/16 melhor para identificá-las. / FAPESP: 2015/18291-7
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