Prevalência e fatores associados com sarcopenia em idosos brasileiros: uma revisão sistemática e metanálise

Abstract

Introduction: Sarcopenia is a muscular disease that influences several homeostatic and functional mechanisms in the geriatric population. Despite being rooted in adverse muscular changes, it affects several organic systems. It can be divided into primary and secondary, the former originating in the aging of the individual and the latter due to associated comorbidities, where the prevalence in the elderly population is widely variable, as it ranges from 5% to 50% depending on sex, age, pathological conditions and mainly the diagnostic criteria. There is a pressing need for advances in the study of this pathology and to offer better diagnostic methods, prevention, and individualized health care. Physical activity and nutrition are the main ways studied to prevent, treat, and even reverse sarcopenia and to date, they offer better results in their approach. Objectives: To estimate the prevalence and cumulative incidence of sarcopenia in Brazilian elderly people living in the community and identify factors associated with this condition. Methods: Systematic review and meta-analysis. Searches were carried out in the LILACS, EMBASE, SciELO, AMED, CINAHL and MEDLINE/PubMed databases, with descriptors Brazil and sarcopenia, from 2005 to 2023. Observational studies were included, and assessments of risk of bias and quality of evidence were using the Joanna Briggs tool. All diagnostic recommendations were used to identify sarcopenia in studies according to publication date. The combined prevalence was estimated by the proportion of individuals with sarcopenia in the total sample of each included study. The pooled associated factors were calculated or obtained using odds ratios (OR) from the data reported in the included studies. The meta-analysis was performed using a random effects model. Results: A total of 53 studies were included grouping 17,555 participants. The overall prevalence of sarcopenia was 18% (95%CI=13.5–22.7%). The cumulative incidence of sarcopenia, considering a projection of the Brazilian elderly population in the period 2012-2023 (n=~26,723,827), was 0.13 (95%CI=0.13– 0.14) per 1,000 elderly people. The factors significantly associated with sarcopenia were: female sex (OR=0.67, 95%CI=0.45–0.99); advanced age 70–79 years: OR=1.50; 95%CI=1.13–1.99 and ≥80 years: OR=4.01; 95%CI=2.12–7.58); higher education level (OR=0.73, 95%CI=0.56–0.96); osteoporosis (OR=2.02, 95% CI=1.28– 3.18); depression (OR=1.17; 95CI%=1.07–1.27); falls (OR=1.30, 95%CI=1.13–1.51); and hospitalization (OR=2.24, 95%CI=1.35–3.71). Conclusion: The overall prevalence of sarcopenia was 18%. The factors that provide greater risks of developing the disease were advanced age, osteoporosis, depression, falls and hospitalization, while the factor that proved to be the lowest risk was higher education. These findings provide evidence for early identification of individuals at high risk for sarcopenia who may benefit from appropriate interventions to prevent, treat, and even reverse this condition and its complications.