Avaliação do estado nutricional e da sarcopenia em idosos institucionalizados em contexto de estrutura residencial para pessoas idosas

Abstract

Introduction: Nowadays, population is ageing on a global scale and institutionalization is playing an increasingly important role. The institutionalized elderly are more vulnerable to deterioration in their nutritional and functional status. The aim of this study was to assess the risk, nutritional status and sarcopenia in an institutionalized elderly population. Methods: This prospective observational study included 82 participants (>55y) admitted up to 31/01/2024 and with informed and voluntary consent. Patients with amputations, hemodialysis, poorly controlled and severe psychiatric illness, acute infections and active cancer were excluded. Assessment and data collection was carried out for: a) nutritional risk assessment ­ Mini Nutritional Assessment (MNA); b) assessment of nutritional status ­ body weight and height, body mass index, calf circumference (CC), mid­upper arm circumference (MUAC) and waist circumference; c) assessment of sarcopenia ­ application of the SARC­F, handgrip strength (HGS), CC and gait speed test; d) assessment of food intake. Results: The MNA identified 45.1% of participants at risk of malnutrition and 22.0% malnourished. 25.6% were underweight and the majority (48.8%) overweight. There was a prevalence of 14% sarcopenia and 7% severe sarcopenia, with 72.3% of the participants having a SARC­F score predictive of sarcopenia, 78% of the men and 88% of the women having HGS values indicative of probable sarcopenia and 93% of the participants having gait speed≤0.8 m/s. There were significant correlations between age and BMI (­0.389), MUAC (0.319), CC (­0.217), number of antecedents (0.232) and HGS (­0.333). Dependence in activities of daily living is significantly associated with MNA (­0.694), BMI (­0.263), MUAC (­0.325), CC (­0.354), HGS (­0.442) and SARC­F (0.519). MNA was significantly associated with SARC­F (­0.541), HGS (0.510), CC (0.610) and gait speed (0.536). A total of 329 meals were evaluated, and the intake of energy, carbs, lipids, linoleic acid, vitamin D, alpha­tocopherol, riboflavin, B12, folates, potassium, calcium, magnesium, iron, zinc, cholesterol and water was lower than recommended. The intake of protein, fiber and saturated fat in this study seems to be similar to what is recommended, and the intake of vitamins A, C, thiamine and niacin, the minerals sodium and phosphorus, and sugar and salt is above the recommended intake. Conclusion: The high prevalence of overweight is concomitant with the high prevalence of malnutrition and sarcopenia, as well as inadequate food intake in this population.

Date of Award	7 Nov 2024
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Marta Correia (Supervisor), Ana Maria Gomes (Co-Supervisor) & Teresa R.S. Brandão (Co-Supervisor)