Maciel, Álvaro Campos CavalcantiMacedo, Sabrina Gabrielle Gomes Fernandes2023-02-152023-02-152023-01-18MACEDO, Sabrina Gabrielle Gomes Fernandes. Exploração e comparação de pontos de corte para o rastreio da sarcopenia em idosos comunitários: resultado do estudo Pro-Eva. Orientador: Álvaro Campos Cavalcanti Maciel. 2023. 185f. Tese (Doutorado em Fisioterapia) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2023.https://repositorio.ufrn.br/handle/123456789/51307INTRODUCTION: Skeletal muscle tissue is an important component for the study of the health condition and nutritional status of the older people and is of great importance for activities such as walking, mobility and functional independence. Identifying the reduction in strength and skeletal muscle mass (SMM) are essential for establishing the diagnosis of sarcopenia, therefore, their measurements need to be feasible for research and clinical practice, especially regarding low-income and few technological resources, as is the case of the underprivileged population living in northeastern Brazil. In view of this, it is necessary to understand what exists in the literature regarding the available cutoff values and what other evaluation strategies can be used, considering the differences in body composition and context in which the older population it's inserted. OBJECTIVES: #Article 01: Report the experience of implementing and developing the ProEva Study and presenting its preliminary results, regarding the application of the Health Handbook for the Elderly (CSPI); #Article 02: To analyze, through a Systematic Review (SR), the different point values for handgrip strength (HGS) adopted for men and women in the screening of sarcopenia; #Article 03: Develop cut-off values for sarcopenia screening in community-dwelling older living in northeastern Brazil and compare the prevalence between the values defined by consensus and the values established for the studied population; #Article 04: To analyze the cross-validity of five prediction equations for screening MME in older community-dwelling. METHODS: This thesis comprises four articles: The first is an experience report with preliminary data from 996 elderly people, evaluated through CSPI. The second article is RS, which carried out a survey on the cutoff values for handgrip strength (HGS) used in sarcopenia screening and had as inclusion criteria observational studies published in the last 10 years that used dynamometry as a screening method of low muscle strength in the diagnosis of sarcopenia. Article 03 is a cross-sectional study (N=1290) that developed cutoff values for the variables HGS, SMM, gait speed and physical performance using the 20th percentile. The fourth study is a methodological one (N=682) composed of older community-dwelling.in the city of Parnamirim/Rio Grande do Norte, aged 60 years or older, who were evaluated for their MME using bioelectrical impedance (BIA) and five prediction equations and then the cross-validation test (paired t-test, Pearson correlation (r) and multiple linear regression to calculate the estimated standard error (EPE) and coefficient of determination (R²)), then the agreement between the analyzed variables was calculated through of the Bland-Altman test. All studies, except for RS, were approved by the Ethics and Research Committee of the Federal University of Rio Grande do Norte (CEP/UFRN). RESULTS: In Article 01, 996 older community-dwelling were evaluated, with a mean age of 70.3 years, among them, 61.3% were women. About the assessment carried out by the CSPI, it can be noted that chronic conditions such as diabetes mellitus (22.5%), arterial hypertension (29.2%), stroke (16.2%) and anemia (5.8%) were the most prevalent. In the anthropometric assessment, the mean body mass index (BMI) was 27.8 kg/m², reflecting the overweight category and the prevalence of individuals with calf circumference < 31 cm was 27.9% (low muscle mass). For Article 02 (RS), 19,730 references were initially identified, of which 62 were included at the end. All analyzed studies used algorithms or definitions of sarcopenia already established in the literature, among these, 16 developed specific values of cutoff points considering the studied population. In Article 03, the elderly had a mean age of 69.5 years and 62.5% were women. As for the cutoff values developed, considering the local population, the following values were observed: HGS=25.3 kg for men and 16 kg for women; SMM= 7.88 kg/m² and 5.52 kg/m², for men and women, respectively. For gait speed, a value of 0.71 m/s was found for men and 0.63 m/s for women. Regarding the prevalence analysis for both sexes, a reduction in values was observed when the FNIH and IWGS consensus algorithms were adopted, and the cutoff points developed for the present population were used. In Article 04, the sample consisted of elderly people with a mean age of 70.06 (±7.06) years and mostly women (60.7%). When comparing the means of the criterion measure (BIA) (6.7±1.1) and the anthropometric equations, it was seen that the Baumgartner Equation presented a higher mean (12.7± 1.4) and a greater difference in relation to the criterion measurement (-6.06kg). As for the cross-validity analysis, only the Visvanhatan Equation 02 met the validity criteria proposed by Lohman (p-value > 0.05, EPE = 0.602 and R²= 0.74), in addition to presenting a smaller bias (0.04) and a smaller interval between the limits of agreement, when analyzing the BlandAltman results, when compared to bioimpedance (BIA). CONCLUSION: It is concluded that: 1. The article presents a proposal for the management of CSPI, bringing in an innovative way information that can subsidize similar initiatives that seek to strengthen the use of the booklet in primary health care environments; 2. There are a variety of cutoff values available in the literature to define low strength and low muscle mass, and this heterogeneity may vary according to sex and the location where the population was evaluated; 3. The specific cutoff points for the population of northeastern Brazil were different from those already established in the literature, thus being able to influence the prevalence of sarcopenia, overestimating or underestimating this value; 4. Only one equation, which uses simpler variables (gender, weight and height), showed good validity when compared to the criterion measure (BIA).Acesso AbertoSarcopeniaEnvelhecimentoIdosos comunitáriosValores de referênciaPrediçãoAntropometriadoctoralThesisCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL