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Previous issue date: 2018-07-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Fragility is a common clinical syndrome in the elderly, which causes
great risks to health, disabilities, hospitalizations and consequently a high risk of
mortality. The available knowledge about the multiple aspects of fragility in the elderly
suggests that it is a predictor of changes in body composition, with a decline in lean
mass, and in this way, a relevance in the study of the subject in long-lived patients is
observed. In this aspect, the present study proposes the use of Ultrasound (US)
because it is a portable method, with ease of handling and not be influenced by
skinfolds, which minimizes possible inter and intra-rater variations, therefore, with
greater reliability in relation to the results presented. Objectives: To identify the
characteristics of the body composition through the US in the groups of non-frailty
and frailty oldest-old. Methods: The greatest possible number of oldest-old were
traced through the Geriatrics General Ambulatory of Hospital S?o Lucas / PUCRS.
Personal and social data were collected through a questionnaire. Fragility data were
obtained through five phenotypes. Body composition data were obtained through the
portable US. For the analysis of the data, the sample was separated into two groups,
according to the classification of fragility: frailty and non-frailty. Percentage
differences between the categorical variables were calculated through the creation of
cross tables between the variables. Numerical variables were presented through
means, standard deviations and variances. Results: 52 elderly people with a mean
age of 90.10 ? 4.49 years were evaluated. 63.5% were classified as non-frailty and
36.5% frailty. The majority of the sample is composed of women (73.1%). White race
totals 86.5% and 80.5% are widowers. 31.6% of the frailty oldest-old live alone. The
average amenities were higher for the frailty (3.21 ? 1.14) compared to non-frailty
(2.15 ? 1.67). In the analysis of schooling, those who reported having elementary
education (? 8th grade) had a higher odds ratio [RP1,22 (CI95% 1.00-1.49)] to
develop fragility compared to the reference category (? high school) (p = 0.046).
Through the classification of the percentage of body fat (%F) by the US, it was
observed that the female longevity with scores above 33 %F, presented a higher
odds ratio [RP1,81 (IC95% 1,30-2, 52)] to develop fragility compared to the category
with the reference %F (<29 %F) (p <0.001). For males, those who obtained scores
above 26 %F had a greater chance [RP1,81 (IC95% 1.30-2.52)] of developing
fragility compared to the category with the reference %F (<23 %F) (p <0.001).Conclusion: The present study showed persuasive results between fragility syndrome
and body composition. Through the analysis of body composition by Ultrasound and
according to the points of cuts predicted in the literature, it was possible to identify
associations between obesity and increased risk of frailty in longevity. It was
concluded that, the higher the body fat levels and the lower the lean mass
(sarcopenic obesity), the greater the level of fragility of the longevity above 80 years
of age. / Introdu??o: Fragilidade ? uma s?ndrome cl?nica comum em idosos, que ocasiona
grandes riscos para a sa?de, incapacidades, hospitaliza??es e como consequ?ncia
grande risco de mortalidade. O conhecimento dispon?vel sobre os m?ltiplos aspectos
da fragilidade em idosos sugerem que esta seja preditora de altera??es na
composi??o corporal, com decl?nio da massa magra, e desta maneira, observa-se
uma relev?ncia no estudo do tema em pacientes longevos. Neste aspecto, o
presente estudo prop?e o uso do Ultrassom (US) por ser um m?todo port?til, com
facilidade de manuseio e n?o ser influenci?vel pelas dobras cut?neas corporais, o
que minimiza poss?veis varia??es inter e intra-avaliador, portanto, com maior
confiabilidade em rela??o aos resultados apresentados. Objetivos: Identificar as
caracter?sticas da composi??o corporal atrav?s do US nos grupos de longevos n?o
fr?geis e com fragilidade. M?todos: Os longevos foram rastreados atrav?s do
Ambulat?rio Geral de Geriatria do Hospital S?o Lucas/PUCRS. Os dados pessoais e
sociais foram coletados atrav?s de um question?rio. Dados de fragilidade foram
obtidos atrav?s de cinco fen?tipos. Dados de composi??o corporal foram obtidos
atrav?s do US port?til. Para a an?lise dos dados, a amostra foi separada em dois
grupos, de acordo com a classifica??o da fragilidade: fr?gil e n?o fr?gil. As vari?veis
num?ricas foram apresentadas atrav?s das m?dias, desvio padr?es e vari?ncias.
Aprovado pelo CEP-PUCRS sob n?mero CAEE 68165117.6.0000.5336. Resultados:
A amostra foi composta por 52 idosos longevos com idade m?dia de 90,10?4,49
anos. 63,5% foram classificados como n?o-fr?geis e 36,5% fr?geis. A maioria s?o
mulheres (73,1%). Ra?a branca soma 86,5% e 80,5% s?o vi?vos. 31,6% dos
longevos fr?geis moram sozinhos. A m?dia de comorbidades foi maior para os
fr?geis (3,21?1,14) comparada aos n?o-fr?geis (2,15?1,67). Na an?lise da
escolaridade, longevos que relataram ter ensino fundamental (?8?s?rie),
apresentaram maior raz?o de chance [RP1,22(IC95%1,00-1,49)] de desenvolver a
fragilidade frente ? categoria de refer?ncia (?Ensino M?dio) (p=0,046). Atrav?s da
classifica??o do percentual de gordura corporal (%G) pelo US, observou-se que os
longevos do sexo feminino com escores acima de 33 %G, apresentaram maior raz?o
de chance [RP1,81(IC95%1,30-2,52)] de desenvolver a fragilidade frente ? categoria
com o %G de refer?ncia (<29%G) (p<0,001). Para o sexo masculino, os que
obtiveram escores acima de 26 %G, apresentaram maior chance
!5
[RP1,81(IC95%1,30-2,52)] de desenvolver a fragilidade frente ? categoria com o %G
de refer?ncia (<23%G) (p<0,001). Conclus?o: O presente estudo mostrou resultados
persuasivos entre a s?ndrome de fragilidade e a composi??o corporal. Atrav?s das
an?lises de composi??o corporal por Ultrassom e conforme os pontos de cortes
preditos pela literatura, foi poss?vel identificar associa??es entre obesidade e
aumento do risco de fragilidade em longevos. Concluiu-se que, quanto maiores os
n?veis de gordura corporal e menores os de massa magra (obesidade sarcop?nica),maior ? o n?vel de fragilidade dos longevos acima de 80 anos de idade.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8386 |
| Date | 27 July 2018 |
| Creators | Ribeiro, Andr? |
| Contributors | Schneider, Rodolfo Herberto |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 8969645070886364160, 500, 600, 500, 600, -224747486637135387, -969369452308786627, 3590462550136975366 |
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