Impacto de um Programa do Exercício Físico Comunitário para Idosos na Progressão da Sarcopenia: 2 anos de follow-up.

Abstract

Introduction: Aging population presents growing challenges in health promotion, especially for conditions like sarcopenia, which affects muscle mass and strength in older adults, compromising their independence and quality of life. This study investigated the impact of a community exercise program called "Mais e Melhores Anos" on the modulation of sarcopenia and other variables associated with physical fitness and health. Objectives: i) Evaluate if participation in the program over two years brought significant improvements in the sarcopenia status of participants; ii) Characterize the sample profile in terms of age, education, weight, height, BMI, TUG, MMSE, and VAS; iii) Compare the variables of muscle strength, aerobic capacity, and dynamic balance with reference values for the elderly portuguese population; iv) Analyze the prevalence of associated geriatric syndromes (frailty, cognitive impairment, falls risks); v) Evaluate the evolution of sarcopenia states over the two years. Methodology: The two-year observational longitudinal study included 458 participants (mean age 74.6±6.4 years), with assessments conducted at the beginning and end of each academic year. The program offered diverse physical activities such as hidrogymnastics, Pilates, yoga, walking, and functional exercises. Parameters such as upper and lower body strength, aerobic capacity, and balance were measured. Based on the physical assessment, physical fitness was explored compared to reference levels for the portuguese population, and the prevalence of geriatric syndromes (frailty, risk of falls, and cognitive deficit) related to the prevalence of sarcopenia was examined. Data were analyzed using descriptive and inferential statistics through SPSS v29 software. The adopted significance level for the p-value was p≤0.05. Results: A total of 458 participants were evaluated (67.5% women and 32.5% men), with a mean age of 74.6±6.4 years. Of these, 23.4% were classified as having probable sarcopenia, with the majority being men (78.5%). Most cases of probable sarcopenia were in the age group of 70 to 74 years (38.3%) and were overweight (61.2%). Among participants with probable sarcopenia, 12.5%, 97.2%, 22.4%, and 36.4% had aerobic capacity, upper limb strength, lower limb strength, and dynamic balance below the 50th percentile, respectively. The prevalence of geriatric syndromes in participants with probable sarcopenia was high, with 99.1% presenting frailty, 1.9% risk of falls, and 40,9% cognitive deficit. At the end of the program, the prevalence of probable sarcopenia increased by 11%, with a reversal in 2.6% of cases. The majority of participants remained classified as normal (63.8%). Conclusion: The community program demonstrated a positive impact on the progression of probable sarcopenia, with reversal of some cases and maintenance of normal condition for the majority of participants. However, greater control of adherence is recommended, including resistance physical exercise and nutritional support, to minimize the risk of developing sarcopenia in initially normal individuals.