Browsing by Author "Rico, Miguel Toscano"
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- DeSaFIo-ME: desnutrição, sarcopénia, fragilidade e medicação na pessoa idosaPublication . Cebola, Marisa; Tomás, Maria Teresa; Costa-Veiga, Ana; Rico, Miguel Toscano; Coelho, André; Mendes, Diana; Duque, Sofia; Galán-Mercant, Alejandro; Mendes, Lino; Marinho, Aníbal; Guerreiro, AntónioO envelhecimento ativo é definido pela Organização Mundial da Saúde (OMS) como o "processo de desenvolver e manter a capacidade funcional que promove o bem-estar da população idosa". No processo de envelhecimento são frequentes algumas alterações a nível físico, como alterações na composição corporal, diminuição na força muscular, flexibilidade, maior sensação de fadiga, que estão muitas vezes associadas a situações de doença. Ao associar ao processo de envelhecimento uma situação de doença, como obesidade, diabetes mellitus, dislipidemia, doença cardiovascular e alterações músculo-esqueléticas como a osteoartrite, osteoporose, entre outras, é previsível encontrar frequentemente diminuição da força muscular, flexibilidade e maior sensação de fadiga. Estas situações surgem mais cedo (por vezes a partir dos 30 anos e com maior intensidade a partir dos 50 anos), mas só mais tarde é que surgem os sinais e sintomas. Mas não tem que ser assim! As situações não são todas iguais! Há pessoas idosas que mantiveram estilos de vida saudáveis ao longo da sua vida e neste momento têm uma vida ativa e há outras em que as alterações fisiológicas são mais marcadas. A abordagem deve ser multidisciplinar para que todas as dimensões do envelhecimento sejam avaliadas e sejam preconizadas medidas que previnam/retardem o aparecimento/agravamento de situações mais específicas, nomeadamente desnutrição, sarcopénia e fragilidade. Com esta leitura pretende-se dar indicações para que se possa ter um estado nutricional adequado e manter hábitos de prática de atividade física.
- Malnutrition and body composition in elderly populationPublication . Cebola, Marisa; Mendes, Diana; Costa-Veiga, Ana; Tomás, Maria Teresa; Coelho, André; Mendes, Lino; Rico, Miguel Toscano; Guerreiro, António SousaIntroduction: Ageing leads to an increase in chronic disease’s prevalence, change in body composition: increased fat mass and decreased lean mass that can lead to malnutrition. Objectives: The aim was relating malnutrition with depletion of lean mass and alteration of fat mass. Materials and methods: Cross-sectional study, developed in the district of Lisbon, in the period from January 1, 2019, to June 30, 2019. Elderly people (≥ 65 years) admitted to the Internal Medicine Unit of a central hospital (up to 72 hours) were eligible for the study. The elderly participants had to present the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge and understanding of the objectives of the study that allowed free and informed decision making. The nutritional assessment was performed through the MNA-LF® and the analysis of the body composition through the measurement of the calf circumference and triceps skinfold. Results: n=38 patients, with a mean age of 78.8 + 5.8 years (70-91), 50% (n=19) males and 73.6%. At hospital admission 7.9% (n=3) were malnourished, 39.5% (n=15) presented nutritional risk, 34.2% (n=13) presented depletion of lean mass and 31.6% (n=12) depletion of fat mass. When we reported the presence of malnutrition with the calf circumference and tricipital skin fold, there was a statistically significant correlation (4=0,04; r=0,05). Malnourished patients presented the depletion of lean mass and fat mass. Discussion/Conclusion: The nutritional assessment using the body composition analysis presents extreme importance in the hospital admission, which allows better performance of the nutritional support adapted to each elderly and better nutritional goals. Signaling the patients who need intervention alert all the clinical team to the importance of nutritional intervention also in the community.
- Sarcopenia and risk of fall in elderly admitted to hospitalPublication . Monteiro, Catarina; Mendes, Diana; Cebola, Marisa; Carolino, Elisabete; Mendes, Lino; Rico, Miguel Toscano; Guerreiro, AntónioIntroduction: Sarcopenia, a progressive and widespread disease of the skeletal muscle, has been a topic of interest. This age-related disease is known to be highly associated with disability, functional decline, frailty and falls. Aims: Relating sarcopenia with the risk of falls. Materials and Methods: Cross-sectional study, developed in Lisbon, in the period from April 22 to July 5, 2019. Elderly people (≥ 70 years) admitted to a hospital institution (up to 72 hours) with the capacity to make their informed consent, without the intervention of any element of coercion, with enough knowledge of the aims of the study that allowed free and informed decision making were admitted to the study. Sarcopenia was assessed through the European Working Group on Sarcopenia criteria in Older People 2 (EWGSOP2), which include the evaluation of the grip strength (GS), appendicular skeletal muscle mass (ASMM) predicted by bioelectrical impedance analysis and physical performance (gait speed). The risk of falls was assessed according to the Morse Scale. Results: n=32 patients, with a mean age of 79.7 + 5.9 years (70-91). At hospital admission 93.8% (n=30) were sarcopenic, 100% (n=30) presented low GS, 75% (n=24) had low ASMM and 3.1% (n=1) had normal gait speed. There was no significant correlation between the Morse Scale and the GS (r=-0.471; p=0,056) and the ASMM (r=0,017; p=0,948). There was a significant correlation between the gait speed test and the Morse Scale (r =-0.689; p=0.002). Patients with gait difficulties are at increased risk of falling. Discussion/Conclusion: The sarcopenia and risk of fall assessment are extremely relevant at hospital admission. It demonstrates the need to establish protocols to evaluate the mentioned parameters of the algorithm and to intervene in this population since the factors that constitute the algorithm proposed by EWGSOP2 tend to worsen during hospitalization.