Prevalence and associated factors of sarcopenia, dynapenia, and sarcodynapenia in community-dwelling elderly in São Paulo - SABE Study

Alexandre, Tiago da Silva; Duarte, Yeda Aparecida de Oliveira; Santos, Jair Lício Ferreira; Lebrão, Maria Lúcia

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 21 (Suppl 02) • 2018 • https://doi.org/10.1590/1980-549720180009.supl.2 copy

Prevalence and associated factors of sarcopenia, dynapenia, and sarcodynapenia in community-dwelling elderly in São Paulo - SABE Study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objectives:

To estimate the prevalence of sarcopenia, dynapenia, and sarcodynapenia and associated factors in older adults in the city of São Paulo, Brazil.

Methods:

A population-based, cross-sectional study was conducted with 1,168 older adults who participated in the third wave of the Health, Well-being, and Aging study in 2010 (SABE study). Men and women with skeletal muscle mass ≤ 8.90 and ≤ 6.37 kg/m², respectively, were considered sarcopenic. Men and women with grip strength < 30 and < 20 kg, respectively, were considered dynapenic. Those with both conditions were considered sarcodynapenic. Sociodemographic, behavioral, clinical, nutritional, and biochemical characteristics were investigated as factors associated with each of the three conditions using multinomial logistic regression.

Results:

Theprevalence of sarcopenia, dynapenia, and sarcodynapenia was 4.8% (95%CI 3.6 - 6.3), 30.9% (95%CI 27.5 - 34.6) and 9.0% (95%CI 7.2-11.3), respectively. An increase in age and malnutrition was associated with all the three conditions. Cognitive impairment was associated with both dynapenia and sarcodynapenia. Schooling, current smoking habit, and not having a marital life were associated with sarcopenia. Osteoarthritis, schooling, being an ex-smoker, and low hemoglobin were associated with dynapenia. Smoking habit and the risk of malnutrition were associated with sarcodynapenia.

Conclusion:

Dynapenia is more prevalent among older adults, followed by sarcodynapenia, and sarcopenia. With the exception of age, schooling, and malnutrition, the factors associated with sarcopenia and dynapenia are different. However, there are similarities in some associations regarding the presence of sarcodynapenia.

Keywords:
Sarcopenia; Dynapenia; Muscle Weakness; Muscle Skeletal; Aged; Prevalence

Sociodemographic variables
Age	69.8 (SD = 0.6)
Gender (female)	60.4% (n = 752)
Marital status (married)	55.8% (n = 592)
Income
> BRL 3,110.00	3.5% (n = 39)
> BRL 1,244.00 and ≤ BRL 3,110.00	14.0% (n = 175)
≤ BRL 1,244,00	82.2% (n = 953)
Not informed	0.3% (n = 1)
Schooling	4.4 (SD = 0.3)
Behavioral variables
Smoking
Nonsmoker	50.9% (n = 610)
Ex-smoker	36.8% (n = 430)
Smoker	12.2% (n = 127)
Not informed	0.1% (n = 1)
Weekly intake of alcohol
Do not consume	68.3% (n = 829)
Consume once a week	19.2% (n = 219)
Consume 2-6 times a week	6.6% (n = 67)
Consume every day	5.9% (n = 53)
Sedentary lifestyle	36.1% (n = 435)
Clinical status
Hypertension (yes)	66.8% (n = 789)
Diabetes (yes)	26.2% (n = 304)
Lung disease (yes)	9.5% (n = 111)
Heart disease (yes)	23.1% (n = 281)
Stroke (yes)	6.5% (n = 86)
Osteoarthritis (yes)	32.4% (n = 396)
Fall in the last 12 months (yes)	29.7% (n = 365)
Hospitalization in the last 12 months (yes)	10.6% (n = 124)
Mini Mental State Examination (≤ 12 points)	8.9% (n = 144)
Geriatric Depression Scale(≥ 6 points)	15.0% (n = 145)
Mini Nutritional Assessment - (17 ≥ MNA® ≤ 23.5)	18.2% (n = 238)
Mini Nutritional Assessment - (MNA® < 17 points)	1.6% (n = 20)
Biochemical analysis
Hb < 12 mg/dL in women and < 13 mg/dL in men	7.5% (n = 102)
Urea ≥ 40 mg/dL	36.9% (n = 454)
Creatinine > 1.0 mg/dL	33.3% (n = 386)
Calcium < 4.25 mEq/L	10.1% (n = 106)
Calcium > 5.05 mEq/L	1.2% (n = 11)
Phosphorus < 2.5 mg/dL	2.4% (n = 29)
Albumin < 3.4 g/dL	3.8% (n = 54)
CRP > 5.0 mg/L	24.6% (n = 276)
HbA1c > 6.0%	36.4% (n = 409)
Fibrinogen > 400 mg/dL	20.2% (n = 244)

	Sarcopenia		Dynapenia		Sarcodynapenia
	%	95%CI	%	95%CI	%	95%CI
Men (n = 416)	5.5 (n = 26)	(3.5 - 8.4)	25.8 (n = 127)	(21.9 - 30.1)	6.9 (n = 47)	(4.9 - 9.7)
60 - 69 years (n = 193)	2.8 (n = 7)	(1.3 - 5.9)	19.2 (n = 40)	(14.7 - 24.7)	1.2 (n = 2)	(0.3 - 4.5)
70 - 79 years (n = 113)	8.8 (n = 10)	(4.5 - 16.5)	30.7 (n = 38)	(22.8 - 39.9)	8.2 (n = 9)	(4.0 - 15.9)
80 years or older (n = 110)	10.2 (n = 9)	(5.6 - 17.9)	44.7 (n = 49)	(34.6 - 55.3)	31.1 (n = 36)	(21.5 - 42.6)
Women (n = 752)	4.3 (n = 33)	(3.0 - 6.0)	34.4 (n = 276)	(30.0 - 39.0)	10.4 (n = 101)	(8.0 - 13.3)
60 - 69 years (n = 340)	3.5 (n = 14)	(2.1 - 6.0)	26.6 (n = 92)	(21.0 - 33.2)	1.5 (n = 6)	(0.7 - 3.3)
70 - 79 years (n = 220)	5.2 (n = 11)	(2.5 - 10.7)	41.5 (n = 94)	(34.4 - 48.9)	13.6 (n = 28)	(9.7 - 18.8)
80 years or older (n = 192)	4.8 (n = 8)	(2.4 - 9.4)	46.1 (n = 90)	(39.2 - 53.1)	33.2 (n = 67)	(26.5 - 40.6)
Total (n = 1,168)	4.8 (n = 59)	(3.6 - 6.3)	30.9 (n = 403)	(27.5 - 34.6)	9.0 (n = 148)	(7.2 - 11.3)

Variables	Sarcopenia		Dynapenia		Sarcodynapenia
Variables	RRR	95%CI	RRR	95%CI	RRR	95%CI
Age (60 - 69 years)	1.00		1.00		1.00
Age (70 - 79 years)	3.32	(1.76 - 6.23)	1.99	(1.44 - 2.76)	11.51	(4.65 - 28.47)
Age (80 years or older)	9.79	(4.31 - 22.23)	6.13	(3.71 - 10.11)	78.98	(30.26 - 206.13)
Mini Mental State Examination (≥ 13 points)	1.00		1.00		1.00
Mini Mental State Examination (≤ 12 points)	1.40	(0.40 - 4.92)	4.69	(2.84 - 7.74)	3.99	(1.90 - 8.36)
Osteoarthritis (no)	1.00		1.00		1.00
Osteoarthritis (yes)	0.84	(0.40 - 1.84)	1.68	(1.16 - 2.45)	0.95	(0.59 - 1.53)
Hb ≥ 12 mg/dL in women and ≥ 13 mg/dL in men	1.00		1.00		1.00
Hb < 12 mg/dL in women and < 13 mg/dL in men	1.67	(0.63 - 4.43)	1.99	(1.03 - 3.87)	1.51	(0.66 - 3.44)
Schooling (years)	1.09	(1.03 - 1.16)	0.95	(0.91 - 0.98)	0.98	(0.91 - 1.05)
Non-smoker	1.00		1.00		1.00
Ex-smoker	0.84	(0.41 - 1.73)	0.64	(0.47 - 0.89)	0.69	(0.41 - 1.17)
Smoker	3.14	(1.45 - 6.78)	1.11	(0.62 - 1.97)	3.07	(1.50 - 6.28)
Good nutritional status (MNA® > 23.5)	1.00		1.00		1.00
At risk of malnutrition (17 ≥ MNA® ≤ 23.5)	2.04	(0.89 - 4.92)	1.15	(0.75 - 1.78)	3.95	(2.21 - 7.07)
Undernourished (MNA® < 17)	37.91	(7.48 - 192.28)	2.63	(1.04 - 6.64)	14.74	(4.60 - 66.33)
Married	1.00		1.00		1.00
Not married	3.59	(1.66 - 7.77)	0.93	(0.65 - 1.33)	1.31	(0.69 - 2.50)

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[1] Corresponding author: Tiago da Silva Alexandre. Departamento de Gerontologia da Universidade Federal de São Carlos. Rodovia Washington Luís, km 235, SP 310, CEP: 13565-905, Sala 16, São Carlos, SP, Brasil. E-mail: tiagoalexandre@ufscar.br