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Master's Dissertation
DOI
Document
Author
Full name
Gabriela Cabett Cipolli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Yassuda, Mônica Sanches (President)
Orlandi, Fabiana de Souza
Pavarini, Sofia Cristina Iost
Ribeiro, Sandra Maria Lima
Title in Portuguese
Sarcopenia e comprometimento cognitivo em idosos longevos: resultados do estudo FIBRA
Keywords in Portuguese
Cognição
Idosos
Sarcopenia
Abstract in Portuguese
A relação entre a sarcopenia e o comprometimento cognitivo ainda não foi completamente avaliada, especialmente entre os idosos mais longevos. Sendo assim, foram desenvolvidos um estudo de revisão sistemática com meta-análise e um estudo empírico que compuseram a presente Dissertação. Os objetivos dos estudos foram: 1) identificar estudos prévios que investigaram a associação entre cognição e sarcopenia em idosos; 2) identificar a relação entre cognição e sarcopenia em idosos longevos da comunidade participantes de estudo prévio. No estudo de revisão sistemática com meta-análise, foi possível verificar que dos 274 estudos identificados, 10 foram incluídos na análise qualitativa, e 6 foram elegíveis para a meta-análise. A prevalência média de sarcopenia foi de 10,5%. O comprometimento cognitivo foi observado em 269/673 idosos com sarcopenia (40%), em comparação com 1,616/6,372 idosos não-sarcopênicos (25,3%). A sarcopenia foi significativamente associada ao comprometimento cognitivo (RR agrupado = 2,50; IC95% = 1,26-4,92; p = 0,008). A heterogeneidade entre os estudos foi alta e significativa (I² = 84%). O estudo empírico é referente à segunda onda de coleta de dados do estudo Fragilidade em Idosos Brasileiros (FIBRA), com dados coletados junto a 285 idosos da comunidade com 80 anos e mais de idade (M= 84.4 ± 3.9 anos; 68,8% feminino). A sarcopenia foi avaliada pelo instrumento SARC-F + CP e a cognição foi avaliada pelo MEEM e pela M-ACE. A média do escore do MEEM e da M-ACE foi significativamente mais baixa entre os idosos sarcopênico (13.99 ± 6.74) do que os não sarcopênicos (16.14 ± 6.29). Nas análises de regressão logística, a sarcopenia e a idade estiveram significativamente associadas ao comprometimento cognitivo no MEEM e a sarcopenia e a escolaridade estiveram significativamente associadas ao comprometimento da M-ACE. É necessário realizar mais estudos longitudinais para verificar os possíveis mecanismos entre a sarcopenia e a cognição, e também se a sarcopenia pode se fator de risco para o comprometimento cognitivo em idosos
Title in English
Sarcopenia and cognitive impairment in the oldest old: results from the FIBRA study
Keywords in English
Cognition
Elderly
Sarcopenia
Abstract in English
The relationship between sarcopenia and cognitive impairment has not yet been fully evaluated, especially among the oldest old. Therefore, a systematic review with meta-analysis study and an empirical study were developed and compose the present dissertation. The objectives of the studies were: 1) to identify previous studies that have investigated the association between cognition and sarcopenia in the elderly; 2) to identify the relationship between cognition and sarcopenia in the oldest old participants of a previous study in the community. In the systematic review with meta-analysis study, 274 studies were identified, 10 were included in the qualitative analysis, and 6 were eligible for the meta-analysis. The average prevalence of sarcopenia was 10.5%. Cognitive impairment was observed in 269/673 elderly patients with sarcopenia (40%), compared with 1,616/6,372 non-sarcopenic elderly (25.3%). Sarcopenia was significantly associated with cognitive impairment (pooled OR = 2.50, 95% CI = 1.26-4.92, p = 0.008). The heterogeneity among the studies was high and significant (I² = 84%). The empirical study refers to the second wave of data collection from the Fragility in Brazilian Elderly study (FIBRA). Data were collected from 285 elderly in the community aged 80 years and over (M = 84.4 ± 3.9 years, 68.8% female). Sarcopenia was assessed by the SARC-F scale plus calf circumference, and cognition was assessed by MMSE and M-ACE. The mean MMSE and M-ACE scores were significantly lower among the sarcopenic elderly (13.99 ± 6.74) than the non-sarcopenic ones (16.14 ± 6.29). In the logistic regression analyses, sarcopenia and age were significantly associated with cognitive impairment in MMSE, and sarcopenia and schooling were significantly associated with M-ACE impairment. Further longitudinal studies are needed to verify the possible mechanisms between sarcopenia and cognition, and also whether sarcopenia may be a risk factor for cognitive impairment in the older people
 
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Publishing Date
2019-08-16
 
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