Objective: To validate calf circumference as a technology for assessing muscle mass in the elderly. Method: Cross-sectional study with 132 elderly people from Goiânia, Goiás, Brazil. Decreased muscle mass was determined by the skeletal muscle mass index (IME) using Dual Energy X-Ray Absortometry (DEXA). The cutoff circumferences (CC) cutoff points to indicate muscle mass decrease were estimated by ROC curve, sensitivity, specificity and accuracy. Results: The most accurate cut-off points for detecting decreased muscle mass in the elderly were 34 cm for men (sensitivity: 71.5%, specificity: 77.4%) and 33 cm for women (sensitivity: 80.0%; specificity: 84.6%). Conclusion: CC can be used as a measure for early identification of muscle mass decrease in routine evaluations of the elderly in primary care.

Aim. To identify methods, index, diagnostic criteria, and corresponding cutoff points used to estimate the prevalence of sarcopenia in older people in different countries.Methods. A systematic review was carried out in accordance with PRISMA Statement. The search encompassed the MEDLINE and LILACS databases and was executed during March 2012 using the keyword sarcopenia.Results. A total of 671 studies were identified by the search strategy, and 30 meet all inclusion criteria. Specifically for dual-X-ray absorptiometry, prevalence ranged from 2.2% to 95% in men and from 0.1% to 33.9% in women. For bioelectrical impedance analysis, the range was from 6.2% to 85.4% in men and 2.8% to 23.6% in women. Regarding anthropometric and computed tomography, prevalence rates were, respectively, 14.1% and 55.9%.Conclusions. Heterogeneity in prevalence of sarcopenia was identified, due to diagnostic method choice, cutoff points, and, characteristics of the population as well as reference population. These factors should be considered in research designs to enable comparison and validation of results. Despite the limitations of most studies that indicated high prevalence rates, the results indicate the need for early detection of this syndrome.

To conduct a systematic review of the literature on self-assessment of health status in the elderly population. Medline and LILACS were searched following the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Original articles on self-assessment of health status conducted with older Brazilians were selected. The following were examined: general characteristics of the studies, the prevalence of negative self-assessment of health, the factors associated with this negative self-assessment, the question used to inquire about health status and response categories. Of 97 studies identified, 11 met the inclusion criteria. Variations between the studies regarding the formulation of the question and answer choices were identified. The prevalence of negative health self-assessment ranged from 12.6 to 51.9% between studies. The most usual dependent variables associated with negative self-assessment of health were the presence of disease, number of medications, monthly family/household income, hospitalizations, medical office visits, difficulty/inability to perform activities of daily living, presence of depressive and anxiety symptoms, and complaints of insomnia. The heterogeneity of factors associated with a negative self-evaluation indicates that the health of older individuals is defined by determinants that fall within a broad view of health. The standardization of questions and answers for research on self-assessment of health in older people is recommended, since this information will produce knowledge and allow monitoring and comparison of results, and will therefore be useful in guiding decision-making regarding the formulation of health policies for Brazil and Latin America.

Resumo O objetivo deste estudo foi analisar a validade e a acurácia do Índice de Massa Corporal (IMC) e da Circunferência da Cintura (CC) na avaliação de obesidade avaliada pelo excesso de gordura corporal (GC) e propor pontos de corte mais adequados para idosos. Os pontos propostos da literatura IMC (25,27 ou 30 kg/m2) e CC (≥ 102 cm-homens e ≥ 88 cm-mulheres ou ≥ 90 cm-homens e ≥ 80 cm-mulheres) foram avaliados conforme densitometria corporal total. A elevada GC foi definida por percentil > 90. Dos 132 idosos, 60,6% eram mulheres de 60-91 anos. Os pontos de corte recomendados de IMC ≥ 25 e ≥ 27kg/m2 apresentaram desempenhos similares, sendo que o IMC ≥ 30kg/m2 apresentou alta especificidade e baixa sensibilidade no sexo masculino e melhor desempenho para GC nas mulheres. Os pontos de corte convencionais de CC não apresentaram boa sensibilidade/especificidade. Foram propostos novos pontos de corte para IMC (masculino-25 kg/m2; feminino-26,6 kg/m2) e CC (masculino-98,8 cm; feminino-77,8 cm). Estes valores demonstraram sensibilidade e especificidade > 74% e acurácia > 76%. As áreas sob a curva foram > 0,86. O presente estudo propõe a utilização de pontos de corte mais acurados para diagnóstico de obesidade/GC em idosos, sendo para homens IMC 25kg/m2 e CC de 98,8cm e para mulheres IMC de 26,6kg/m2 e CC de 77,8cm, com melhores níveis de sensibilidade e especificidade.

Polypharmacy is a common practice among the elderly, but few studies have evaluated its association with nutritional markers. The aim of this study was to estimate the prevalence of polypharmacy and its association with nutritional markers, chronic diseases, sociodemographic and health variables. This research is part of the Study Elderly/Goiânia, which evaluated 418 elderly community in a cross-sectional design. Polypharmacy was defined as the use of five or more concomitant medications. The following nutritional markers were investigated: BMI, waist circumference, percentage body fat, weight gain and loss, use of diet, daily consumption of fruits, vegetables, skimmed and whole milk. Multivariate analysis was performed using hierarchical Poisson regression, with significance level set at 5%. The prevalence of polypharmacy was 28% (95%CI 23.1 - 32.5), with a significant association with feminine gender, age range 75 - 79 years, eutrophic nutritional status and obesity, use of diet, poor self-rated health and presence of two, three or more chronic diseases. The high prevalence of polypharmacy and its association with nutritional markers and chronic diseases call the attention for the need of nutritional surveillance and monitoring in the elderly.