Sarcopenia e suas relações com as alterações do sono e sintomas depressivos em pacientes idosos de um ambulatório geral

Abstract

In Brazil, it is projected that around 2043, a quarter of the population will be composed of people over 60 years old. With aging, there is an impairment of muscle mass and strength and consequent functional decline. Sleep and mood changes are frequent with older age, and can influence the reduction of functional mobility and physical performance, increasing the risk of adverse events such as physical dependence and falls. The aim of this study was to evaluate the presence of probable sarcopenia and its relationships with sleep disorders, depressive symptoms, muscle strength and physical performance in the elderly. This is a cross-sectional study involving 254 elderly women aged between 60 and 95 years (74±6.9) and BMI between 16.6 and 47.1 kg/m2 (28.7±5.3). The most prevalent comorbidities were osteoarthritis (74.4%), hypertension (72.4%) and diabetes (40.9%). The patients were evaluated with the Geriatric Depression Scale – GDS, Insomnia Severity Index – ISI, Pittsburgh Sleep Quality Index – PSQI and Epworth Sleepiness Scale – ESS. They were also investigated using the Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC-F), muscle strength using the Hand Grip and the Stand-to-Sit test (L-S), and physical performance using the Short Physical Performance Battery (SPPB). Poor sleep quality was frequent (54.7%) and excessive daytime sleepiness (EDS) was observed in some patients (17.3%). The test using the ISI showed that 39.8% had insomnia. It was also found that 41.8% of the elderly had depressive symptoms (GDS). The evaluation with Sarc-F showed that 48.4% of the patients had probable sarcopenia. Probable sarcopenia was also shown in 68.5% of the patients by the SPPB test, in 65% by the L-S test and in 22.8% by the Hand Grip test. Linear regression showed that SARC-F was related to all sleep variables (PSQI, ISI and ESS) and to depressive symptoms (GDS). The Hand Grip was not related to measures of sleep and depressive symptoms. The SPPB and the L-S Test were only related to the GDS. Multivariate and controlled logistic regression showed that, independently, age (OR=1.08, 95% CI 1.02 – 1.14; p=0.005), BMI (OR=1.08, 95% CI 1.01 – 1.15; p=0.029) and depressive symptoms (OR=1.22, 95% CI 1.07 – 1.41; p=0.005) were related to probable sarcopenia. The presented results indicate that therapeutic measures directed at depressive symptoms and combined with traditional therapies such as exercise and adequate nutrition can be an important strategy to reduce sarcopenia.