Resumen de Factors associated with health and intrinsic capacity domain in older adults: a secondary analysis for survey on health, well-being, and aging in Colombia
Summary This research work focuses on the exploration and analysis of the database of the National Study of Health, Well-Being and Aging, SABE Colombia 2015, especially in what has to do with the prevalence of Metabolic Syndrome in the elderly, and its associated factors. The definition of cohort points of handgrip strength, by sex and age in older adults; as well as the probabilities of adverse events for each of the domains of intrinsic capacity. And the mediating role of the speed of gait of the effect of sarcopenia on activities of daily living.
The SABE Colombia 2015 survey aims to investigate the current situation, in the rural and urban environment, of the elderly, from a social determinants of health approach. Within this interest, three secondary studies related to the characteristics concerning the determinants of health, care and of individual, sociodemographic and environmental factors are proposed.
Study 1 (Chapter 2) The purpose of this study to analyze the prevalence of metabolic syndrome and associated risk factors in older individuals aged ≥60 years in Colombia. The data for this study came from a secondary cross-sectional, nationally representative SABE study Survey on Health, Well-Being, and Aging in Colombia, 2015. Setting and participants: A total of 1637 participants (60.7% women, 70.5±7.9 years) from 86 Colombian municipalities participated. A structured questionnaire was used to collect data on socio-demography, lifestyle, and medical conditions. Measurements included anthropometric variables, handgrip strength, high-density lipoprotein cholesterol, triglycerides, fasting glucose, and blood pressure. Univariate and multivariate regression models were established as part of the main analysis. Using the harmonized Joint Scientific Statement criteria, metabolic syndrome was present in 54.9% of the study population, with a higher prevalence among females than males (59.8% vs. 47.3%). Smoking (odds ratio [OR] = 1.59; 95% confidence interval [CI] = 1.03–2.44; p=.034), male gender (OR = 1.38; 95% CI = 1.05–1.82; p=.020) and sarcopenia (OR = 1.63; 95% CI = 1.06–2.52; p=.026) were associated with increased odds of metabolic syndrome. Metabolic syndrome is prevalent in this study population. Smoking, male gender, and sarcopenia are associated with metabolic syndrome. Screening for promotion of healthy lifestyle and nutrition counselling should be offered routinely among this nationally representative sample of Colombian older adults.
Study 2 (Chapter 3) The purposes of this study were three-fold: (1) to describe handgrip strength in older individuals aged ≥ 60 years in Colombia; (2) to identify sex- and age-specific muscle weakness cut-off points in older adults; and (3) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. Methods: A cross-sectional study was conducted in Colombia, among 5,237 older adults aged ≥60 years old (58.5% women, 70.5±7.8 years), according to “SABE Survey 2015”. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e., locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socioeconomic status, urbanicity, body-mass index, smoking status, alcohol intake, drug use, physical activity, and comorbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. Handgrip strength was greater among men than among women (26.7 ± 8.5 kg vs 16.7 ± 5.7 kg, respectively, p<0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity (in men, odds ratio [OR]=0.62, 95% confidence interval [CI] 0.53 to 0.71; p<0.001; and in women, OR=0.79, 95%CI 0.68 to 0.92; p=0.002) than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR=0.47, 95%CI 0.29 to 0.78; p=0.004) than their weaker counterparts. This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.
Study 3 (Chapter 4) The purposes of this study were three-fold: (1) to describe handgrip strength in older individuals aged ≥ 60 years in Colombia; (2) to identify sex- and age-specific muscle weakness cut-off points in older adults; and (3) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. A cross-sectional study was conducted in Colombia, among 5,237 older adults aged ≥60 years old (58.5% women, 70.5±7.8 years), according to “SABE Survey 2015”. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e., locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socioeconomic status, urbanicity, body-mass index, smoking status, alcohol intake, drug use, physical activity, and comorbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. Results: Handgrip strength was greater among men than among women (26.7 ± 8.5 kg vs 16.7 ± 5.7 kg, respectively, p<0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity (in men, odds ratio [OR]=0.62, 95% confidence interval [CI] 0.53 to 0.71; p<0.001; and in women, OR=0.79, 95%CI 0.68 to 0.92; p=0.002) than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR=0.47, 95%CI 0.29 to 0.78; p=0.004) than their weaker counterparts. This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.
