Força de preensão palmar e sobrevida em nonagenários e centenários do Projeto Ampal

Abstract

Introduction: The Multiprofessional Care of Oldest-old Project (AMPAL) of the Institute of Geriatrics and Gerontology of Pontifical Catholic University of Rio Grande do Sul, identified that the nonagenarians and centenarians are the age groups that have increased the most, but them die most due to undefined causes. The aging process and its natural path generate continuous morphophysiological, structural and functional changes that affect survival and quality of life. The handgrip strength test (HGS) is able to provide relevant information in the evaluation of old-adults. It serves as a simple noninvasive measure for muscle weakness. In the population of nonagenarians and centenarians, HGS can have enormous relevance as this is a phase of life in which there is a greater tendency for neuromuscular and biomechanical changes. Thus, this dissertation seeks to present the results of longitudinal follow-up of nonagenarians and centenarians accompanied by AMPAL. Methodology: Longitudinal, observational and analytical study of quantitative nature, using the results of the HGS measured in the first evaluation carried out in AMPAL participants in 2016, at the participants' homes, randomly selected in various neighborhoods of Porto Alegre - RS. The number of months between the first assessment and the date of death or last contact (for survivors) was calculated for survival analysis assessed by simple and adjusted Cox Hazard Regression models. Results: The results of 212 participants, 155 women and 57 men, were evaluated, of which 83 (39%) died during follow-up on 30 August 2019. Only 17% of participants had levels considered normal by the European Consensus on Sarcopenia. In the simple analysis were predictors of survival: age, leaving home weekly, participating in social activities, being able to get out of bed, preparing meals and shopping alone. Also significant were the cognitive performance (Mini-Mental State Examination) of Lower, Upper and Mixed Limbs (measured by the degree of ease in performing activities), Timed Up & Go test (TUG) and FPP. There were no significant predictors: gender and self-rated health. Quartet-adjusted cutoff points were better predictors of survival by 25% for dominant-hand PPF and 50% for non-dominant hand. Significant for the FPP-adjusted analysis: participation in social activities, preparing meals and shopping alone, and functional (cognitive and physical) performance. Conclusion: We concluded that FPP was an important predictor of survival among AMPAL nonagenarians and centenarians. This prediction was independent of other equally significant factors: cognitive and functional (TUG, MI, MS and mixed) performance, participation in social activities, and maintaining the ability to perform daily living activities alone (preparing meals and shopping). We also observed that age was an FPP-dependent predictor for survival, concluding that, in nonagenarians and centenarians, the maintenance of functional performance is more important than age. Non-dominant hand was better predictor of survival in the surveyed participants. Few participants had normal criteria for FPP, according to the European Consensus on Sarcopenia. The results also allow to propose that the FPP reference values in nonagenarians and centenarians: 23KgF for men and 14KgF for women. We also propose reference values for the non-dominant hand in nonagenarians and centenarians: 18KgF for men and 12KgF for women.