Nível de concordância entre os critérios diagnósticos propostos pelo Grupo de Trabalho Europeu sobre sarcopenia em pessoas idosas

Abstract

During aging there are changes in the body composition of individuals, which may result in reduced muscle mass and function, which characterizes the process involved in the etiopathogenesis of sarcopenia, a disease that favors functional decline, risk of falls, fractures, and morbidity and mortality, being more prevalent in elderly individuals. The main objective of this study was to analyze the agreement between the first and the recent European consensus on the diagnosis of sarcopenia in elderly people (EWGSOP 1 and 2) and, as secondary objectives, to evaluate the agreement of the EWGSOP2’s with the SARC-F and SARC-CalF sarcopenia screening questionnaire, as well as possible correlations with nutritional status and body composition of elderly individuals. A cross-sectional study was conducted involving the urban population of Lavras-MG, of both genders, aged ≥ 60 years. Sarcopenia screening was performed using the SARC-F and SARC-CalF questionnaire. For the anthropometric assessment, body weight (kg), height (m), calf circumference (cm) and waist circumference (cm) were measured. Bioelectric impedance (BIA) was used to obtain muscle mass and fat mass. Total skeletal muscle mass and appendicular muscle mass were estimated by equations after BIA. Muscle strength was evaluated by palmar grip strength and physical performance by the usual gait speed test. In determining the prevalence of sarcopenia, the diagnostic criteria proposed by the first and recent European consensus EWGSOP were adopted. The body mass index (BMI) was also calculated; the body fat mass index (FMI) and the muscle quality index (MQI). The study was conducted with 144 participants (82.64% women, 69.61 ± 6.41 years). The results of the present study revealed that using Cohen's Kappa coefficient, there was no agreement (k <0.001) between pre-sarcopenia and probable sarcopenia, and there was a slight agreement (κ between 0.0 and 0.2) between the diagnosed sarcopenia by EWGSOP1 and EWGSOP2. There was no agreement (k <0.001) between probable sarcopenia and SARC-F and SARC-CalF; fair agreement (κ between 0.21 - 0.40) was observed between sarcopenia (EWGSOP2) and both screening questionnaires. Through Spearman's correlation coefficient, a negative correlation (p ≤ 0.025) was observed between the BMI classifications and sarcopenia stages by EWGSOP1; negative correlation between WC and the stages of sarcopenia by EWGSOP1; no correlation was observed between the stages of sarcopenia (by both consensus) and the FMI. The non-agreement between pre-sarcopenia and probable sarcopenia and the slight agreement between sarcopenia diagnosed by EWGSOP1 and EWGSOP2, demonstrates a supposed problem for clinical evaluations, as it is difficult to compare disease prevalence. In the present study, SARC-F and SARC-CalF were not adequate for observing probable sarcopenia. The new definition of sarcopenia (EWGSOP2) did not present correlation with the nutritional status and body composition of the elderly participants.