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      Association between adductor pollicis muscle thickness and nutritional parameters in hospitalized elderly patients Translated title: Asociación entre el espesor del músculo aductor del pulgar y parámetros nutricionales en pacientes ancianos hospitalizados

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          Abstract

          Abstract Introduction: the measurement of the adductor pollicis muscle thickness (APMT) has been investigated as an anthropometric parameter; however, there are few studies related to hospitalized elderly patients. Objective: to analyze the association between APMT and nutritional parameters in hospitalized elderly patients. Method: cross-sectional study made in 331 hospitalized elderly patients. The following variables have been assessed: APMT, Mini Nutritional Assessment(r) (MNA(r)), body mass index (BMI), arm circumference (AC), calf circumference (CC) and handgrip strength (HGS). Results: the mean age was 78.4 ± 9.7 years and 56.8% were women. The women had showed APMT mean values significantly lower than the men (12.67 ± 4.13 mm vs 15.26 ± 4.01 mm), as well as the elderly patients ≥ 80 years old showed APMT values lower than the younger patients (12.62 ± 4.38 mm vs 14.83 ± 3.90 mm). In relation to the APMT classification, the women were more frequently below P5 than the men (89.9% vs 37.1%). In the univariate analysis, the mean values of APMT were significantly lower in the malnourished elderly patients (MNA(r)), thinness (BMI), AC < 21 cm, CC < 31 and HGS < P5, regardless of gender. In the multivariate analysis, APMT remained as a factor independently associated with all nutritional indicators, even when adjusted to age and gender. Conclusion: APMT has associated with all the nutritional parameters investigated, regardless of gender and age, reinforcing its applicability in the nutritional assessment of elderly people.

          Translated abstract

          Resumen Introducción: la medida del espesor del músculo aductor del pulgar (EMAP) ha sido investigada como parámetro antropométrico, pero son escasos los estudios en ancianos hospitalizados. Objetivo: analizar la asociación entre EMAP y parámetros nutricionales en ancianos hospitalizados. Método: estudio transversal con 331 ancianos hospitalizados. Se evaluaron las siguientes variables: EMAP, Mini Nutritional Assessment(r) (MNA(r)), índice de masa corporal (IMC), circunferencia del brazo (CB), circunferencia de la pantorrilla (CP) y fuerza de prensión palmar (FPP). Resultados: el promedio de edad fue de 78,4 ± 9,7 años y el 56,8% eran mujeres. Las mujeres tenían valores medios de EMAP significativamente menores que los hombres (12,67 ± 4,13 mm frente a 15,26 ± 4,01 mm), así como los ancianos ≥ 80 años tenían valores de EMAP inferiores a los más jóvenes (12,62 ± 4,38 mm frente a 14,83 ± 3,90 mm). En cuanto a la clasificación de la EMAP, las mujeres se encontraban con más frecuencia por debajo del P5 que los hombres (89,9% frente al 37,1%). En el análisis univariado, los niveles medios de la EMAP se mostraron mucho más pequeños en los ancianos con desnutrición (MNA(r)), delgadez (IMC), CB < 21 cm, CP < 31 cm y FPP < P5, independientemente del sexo. En el análisis multivariado, la EMAP permaneció como factor independiente asociado a todos los parámetros nutricionales, incluso cuando se ajustó para edad y sexo. Conclusiones: la EMAP se asoció con todos los parámetros nutricionales investigados, independientemente del sexo y de la edad, reforzando su aplicabilidad en la evaluación nutricional de ancianos.

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          Screening for nutritional status in the elderly.

          A comprehensive assessment of nutritional status is a critically important component of any patient evaluation. Based upon clinical information, anthropometric data, and a small number of laboratory investigations, an accurate appraisal of nutritional status should be possible and an appropriate intervention plan can be developed. The actual approach depends on the particular problem discovered. These are discussed in detail elsewhere in this issue.
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            Reference values and determinants for handgrip strength in healthy subjects.

            To determine reference values and associated factors for handgrip strength among healthy adults. Three hundred well nourished (SGA category A) subjects were studied, aged 18-90 years. Handgrip strength (HS) was determined using a hand dynamometer. Adductor pollicis muscle (APM) thickness and other anthropometric variables were also measured. Results were analyzed according to gender and age group. We carried out multiple linear regression in order to identify significant determinants of handgrip strength. HS is significantly associated with gender and decreases after age 60 years (p<0.001). Different reference values for each gender and age category are presented, for both dominant (DHS) and non-dominant hands (NDHS). APM showed a strong correlation with HS (R(2)=0.71 and 0.70, for DHS and NDHS, respectively). This association remained significant after adjustment for other variables such as gender, age and body mass index. Reference values are needed to allow the use of HS as a muscular function assessment tool. Values should be stratified by gender and age group. The combined use of HS and APM may be useful as a method for nutritional assessment.
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              Mulher idosa: suporte familiar ou agente de mudança?

              O TRABALHO buscou mostrar a heterogeneidade da experiência do envelhecimento feminino. Há não muito tempo atrás, o envelhecimento trazia para as mulheres brasileiras, pobreza e isolamento. A grande mudança ocorrida nos últimos vinte anos é que o final da vida ativa e a viuvez não significam mais necessariamente isso. Para uma grande maioria de pessoas, pode significar uma nova fase no ciclo de vida. A universalização da Seguridade Social e a melhoria das condições de saúde trouxeram uma reconceitualização do curso da vida. A última fase da vida deixou de ser residual, vivenciada por uma minoria, para ser uma fase de duração até maior do que a infância e a adolescência. Ou seja, as idosas de hoje estão assumindo papéis não esperados, tornando-se também importante agentes de mudança social.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                October 2018
                : 35
                : 5
                : 1059-1065
                Affiliations
                [2] Porto Alegre orgnamePontifical Catholic University of Rio Grande do Sul (PUCRS) orgdiv1Multiprofessional Integrated Health Residency Program Brazil
                [1] Porto Alegre orgnamePontifical Catholic University of Rio Grande do Sul (PUCRS) orgdiv1Institute of Geriatrics and Gerontology orgdiv2Graduate Programe in Biomedical Gerontology Brazil
                Article
                S0212-16112018000901059 S0212-1611(18)03500501059
                10.20960/nh.1739
                fb4d4c67-1a91-442d-ba9e-256163b3ae12

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 19 December 2017
                : 21 February 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Papers

                Hospitalización,Desnutrición,Evaluación nutricional,Aged,Hospitalization,Anthropometry,Malnutrition,Nutrition assessment,Ancianos,Antropometría

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