Nutritional status, physical performance and functional
                    capacity in an elderly population in southern Brazil

Danielewicz, Ana Lúcia; Barbosa, Aline Rodrigues; Del Duca, Giovâni Firpo

doi:10.1590/1806-9282.60.03.0013

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Original Articles • Rev. Assoc. Med. Bras. 60 (3) • May-Jun 2014 • https://doi.org/10.1590/1806-9282.60.03.0013 copy

Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil

Estado nutricional, desempenho físico e capacidade funcional de uma população de idosos do sul do Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to investigate the association between nutritional status and functional limitation and disability in an elderly population in southern Brazil.

Methods:

epidemiological, cross-sectional household-based study carried out with 477 elderly of both sexes (60 to 100 years). Body mass index (BMI) served to assess the nutritional status: underweight (BMI < 22 kg/m²) and overweight (BMI > 27 kg/m²). The sum score (0-5) obtained in three tests: "chair stand" and "pick up a pen" (measured by time) and standing balance (four static measurements) assessed the functional limitation. The disability was evaluated by the difficulty in performing one or more self-reported tasks related to basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Crude and adjusted analyzes (3 models) were carried out using Poisson regression; prevalence ratios (PR) and 95% confidence intervals (CI) were calculated.

Results:

crude analyzes showed a positive association between underweight and functional limitation (PR = 2.71, 95% CI = 1.63 to 4.51); overweight and disability in ADLs (PR = 2.20, CI 95% = 1.44 to 3.35); overweight and disability in IADLs (PR = 1.56, CI 95% = 1.20 to 2.03). The additional adjustments for gender, age, level of education, living arrangements, current work, cognitive function and number of morbidities reduced the strength of the associations, without changing the statistical strength.

Conclusion:

nutritional status is a factor that is independently and positively associated with functional limitation and disability. We recommend the use of this indicator to monitor the health of the elderly.

aging; nutritional status; activities of daily living; mobility limitation

Variable	n	%^a a Percentage of weighted samples.	95% CI^b b 95% Confidence interval in the weighted sample.
Gender (n = 477)
Female	270	56.8	52.1 - 61.6
Male	207	43.2	38.4 - 47.9
Living arrangement (n = 477)
Living alone	65	13.1	9.9 - 16.3
Accompanied	412	86.9	83.7- 90.1
Currently work (n = 469)
Yes	179	40.3	35.6 - 45.1
No	290	59.7	54.9 - 64.4
Level of education (n = 476)
Illiteracy	90	18.2	14.6 - 21.9
1 year	366	76.3	72.2 - 80.5
2 years or more	20	5.4	3.1 - 7.8
Cognitive function (n = 467)
Normal	412	90.3	87.7 - 93
Altered	55	9.7	7 - 12.3
Number of morbidities (n = 477)
0-2	318	66.9	62.4 - 71.4
3 or more	159	33.1	28.6 - 37.6
Nutritional status (n = 466)
Underweight	47	8.2	5.7 - 10.6
Normal weight	186	38.8	34.1- 43.5
Overweight	233	53	48.2- 57.8
Functional limitation (n = 473)
Yes	123	24	19.9 - 28.1
No	350	76	71.9 - 80.1
IADL (n = 473)
Dependent	218	43.5	38.7 - 48.2
Independent	255	56.5	51.8 - 61.3
ADL (n = 477)
Dependent	125	26.4	22.2 - 30.7
Independent	352	73.6	69.3 - 77.8

Variable	Functional limitation %	Crude analysis		Adjusted analysis
		Crude analysis		Model 1		Model 2		Model 3
		PR (95% CI)	p	PR (95% CI)	p	PR (95% CI)	p	PR (95% CI)	p
Nutritional status			< 0.001		< 0.001		0.002		0.009
Normal weight	15.6	1		1		1		1
Underweight	42.3	2.71 (1.63 - 4.51)		2.43 (1.43 - 4.12)		2.40 (1.46 - 3.95)		2.25 (1.35 - 3.75)
Overweight	23.6	1.51 (0.99 - 2.31)		1.42 (0.93 - 2.19)		1.38 (0.89 - 2.13)		1.39 (0.89 - 2.15)

Variable	Disability %	Crude analysis		Adjusted analysis
		Crude analysis		Model 1		Model 2		Model 3
		PR (95% CI)	p	PR (95% CI)	p	PR (95% CI)	p	PR (95% CI)	p
Instrumental activities of daily living
Nutritional status			0.004		0.010		0.020		0.020
Normal weight	31.5	1		1		1		1
Underweight	45.1	1.43 (0.95 - 2.16)		1.27 (0.85 - 1.90)		1.24 (0.83 - 1.84)		1.15 (0.76 - 1.75)
Overweight	49.2	1.56 (1.20 - 2.03)		1.48 (1.14 - 1.93)		1.48 (1.13 - 1.93)		1.46 (1.11 - 1.92)
Basic activities of daily living
Nutritional status			0.001		0.002		0.003		0.005
Normal weight	14.4	1		1		1		1
Underweight	28.4	1.98 (1.07- 3.64)		1.87 (1.00 - 3.51)		1.75 (0.93 - 3.30)		1.69 (0.88 - 3.24)
Overweight	31.5	2.20 (1.44 - 3.35)		2.12 (1.40 - 3.19)		2.07 (1.37 - 3.14)		2.02 (1.33 - 3.08)

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[1] Correspondence: Departamento de Educação Física - Centro de Desportos, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC - Brazil, Phone/Fax: +55 48 3721-9368. aline.r.barbosa@ufsc.br, alinerb13@yahoo.com.br