Weight loss severity and functional decline among the oldest old in a middle-income country: The FIBRA study longitudinal findings.

BACKGROUND AND AIMS: Nutritional status is a key modifiable risk factor associated with disability, and further evidence suggests that weight change is also linked to this adverse outcome. Thus, this study aims to evaluate weight loss severity and functional decline in instrumental activities of daily living (IADL) in a seven-year period among a sample of Brazilian oldest-old adults. METHODS: Longitudinal prospective study using data from the FIBRA study (Frailty in Older Brazilians), a population-based investigation carried out in 2008/2009, with follow-up data collected in 2016/2017 from participants who were 80 years and older in the follow-up in Campinas, Brazil. Of the 167 participants with complete data in 2016-2017, 16 had improved their functional status and were excluded, so the final sample was restricted to 151 participants who maintained or declined functional status. We considered functional decline when a subject had greater IADL dependencies at follow-up than baseline. Logistic regression was performed to assess the effect of weight loss, according to severity (moderate weight loss: 5-10% of body weight; severe weight loss >10%) in increasing the number of disabilities than the group with stable weight, controlling for covariates (gender, age, education, and morbidity). An alpha level of <5% was adopted. RESULTS: During the follow-up period, 60.3% of the participants kept stable weight, 21.8% had moderate weight loss, and 17.9% had severe weight loss. During the follow-up, only severe weight loss was associated with a higher risk of functional decline (OR = 2.74; p = 0.032). CONCLUSIONS: Severe weight loss was associated with functional decline. This finding reinforces the importance of early identification of weight loss among older adults.

Taste sensitivity throughout age and the relationship with the sleep quality.

OBJECTIVE: The aim of the present study was to evaluate taste sensitivity and sleep pattern throughout age. METHODS: Thirty-five male adults aged (25.05±0.71 years), and twenty- four older adults (68.92 ± 6.43 years) were selected and submitted to sleep evaluation (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale), as well as taste sensitivity. Taste sensitivity was evaluated using three dilutions and the different concentrations were presented for the four basic flavors (salty, sweet, bitter and sour). These samples were encoded with three digits and randomly presented to the participants in 50 mL plastic cups. RESULTS: In both groups, sleep quality was poor (PSQI >5). Older adults presented a negative effect to identify sweet and salty taste and, in this population, sleep time was associated with sweet taste perception. DISCUSSION: We may suggest that aging may cause changes in taste sensitivity, as well as total sleep time was observed to be a significant predictor of sweet taste. Sleep may play an important role in taste sensitivity, although the mechanisms are still unknown. Thus, the results of this research may contribute to the emergence of new studies that seek to better understand this relationship of sleep quality as taste sensitivity.

Association of dynapenia, obesity and chronic diseases with all-cause mortality of community-dwelling older adults: A path analysis.

AIM: The objective of the present study was to evaluate the effect of dynapenia, central obesity and the presence of chronic diseases in 8-year mortality of community-dwelling older adults. METHODS: Participants comprised 610 older adults, aged ≥65 years at baseline, who participated in the "Frailty in Brazilian Older People" study carried out in 2008. Baseline data, such as weight, height, waist circumference, muscle strength, sex, self-reported diseases and physical activity, were assessed. Vital status in 2016 was assessed by Mortality Information System database of Campinas. The χ2 -test and Mann-Whitney U-test were used to compare categorical and continuous variables, respectively. Path analysis was carried out to study the factors associated with mortality. RESULTS: There was a statistical difference between alive and deceased groups for the variables sex, age group, physical activity, waist circumference and dynapenia. Path analysis explored the relationship among the studied variables. Direct paths showed a positive association to mortality for those who presented the combination of more diseases (ß = 0.105), male sex (ß = 0.108), low physical activity (ß = 0.121), low handgrip strength (ß = 0.090) and no central obesity (ß = -0.143). When indirect paths were concerned, variables "central obesity", the presence of "more diseases" and dynapenia had a mediator role. CONCLUSIONS: Central obesity was not positively associated with higher mortality, unless it was associated with the presence of chronic diseases. Dynapenia showed a direct effect on mortality, but not combined with central obesity. The findings of this study shed light on complex relationships between nutritional status and elderly mortality through the use of simple measurements. Geriatr Gerontol Int 2019; 19: 108-112.

Gender Differences in the Incidence and Determinants of Components of the Frailty Phenotype Among Older Adults: Findings From the SABE Study.

OBJECTIVE: To analyze gender differences in incidence and determinants of the components of the frailty phenotype. METHOD: A total of 1,413 older adults were selected in 2006. To estimate the incidence of each frailty component, only individuals who did not exhibit a given component at baseline (independently of the presence of other components) were included in the study. The variables of interest were socioeconomic, behavioral, clinical, anthropometric factors and physical performance. The incidence of each component in 2010 was the outcome. RESULTS: Unintentional weight loss and slowness were more incident in men up to 74 years of age. The other frailty components were more incident in women at all age groups, except weakness. Besides age, the determinants of incidence of the components of frailty were different between genders. DISCUSSION: Strategies for preventing or delaying the installation of frailty need to address gender differences, considering the greater complexity in the network determinants among women.

Similarities among factors associated with components of frailty in elderly: SABE Study.

OBJECTIVE: To analyze similarities among factors associated with the components of frailty in elderly. METHOD: We studied 1,413 elderly from the second wave of the SABE Study in 2006. Each of the five components of the frailty phenotype was considered a dependent variable in the hierarchical logistic regression models. RESULTS: In both genders, age, schooling, sedentary lifestyle, and screening positive for depression were associated similarly with more than one component of frailty. Other similarities were also observed with stroke and screening positive for cognitive decline in men, and number of diseases and gait speed in women. The most similar associations happened between weakness and slowness; weakness, slowness, and LPAL; or weakness, slowness, and exhaustion. DISCUSSION: Encouraging physical activity, screening for and treating depression and treating both diseases of the central nervous system and chronic diseases must be the focus of strategies to avoid, delay, or even remedy frailty.