Banca de DEFESA: MAYARA PRISCILLA DANTAS ARAUJO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : MAYARA PRISCILLA DANTAS ARAUJO
DATE: 22/06/2026
TIME: 09:00
LOCAL: Remota
TITLE:

EVALUATION OF CALF CIRCUMFERENCE IN OLDER ADULTS: ASSOCIATION WITH VULNERABILITY AND ANALYSIS OF ADJUSTMENT BY BODY MASS INDEX

KEY WORDS:

Older adults. Calf circumference. Body mass index. Muscle mass. Vulnerability. Sarcopenia.

PAGES: 50
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

Reduced muscle mass in older adults is associated with adverse health outcomes, such as greater dependence and vulnerability, highlighting the importance of simple, accessible, and feasible methods for its timely identification across different care settings. Among these methods, calf circumference (CC) has been widely used as an anthropometric proxy for muscle mass, although its interpretation may be influenced by nutritional status, particularly in the presence of excess adiposity. This doctoral thesis aimed to analyze the usefulness of calf circumference as an anthropometric marker of muscle mass and its contribution to sarcopenia risk screening in older adults. It comprises three independent cross-sectional studies: 1) a study conducted with 250 residents from eight philanthropic Long-Term Care Facilities for Older Adults (LTCFs), which aimed to evaluate the association between loss of muscle mass and vulnerability; 2) a study conducted with 233 residents from eight LTCFs, which aimed to examine the effect of body mass index (BMI)-adjusted CC on the classification of low CC, considering the cut-off points proposed by the Brazilian Older Adult Health Handbook (CSPI) and by the Brazilian population; and 3) a study conducted with 327 community-dwelling older adults in Brazil (n=253) and Spain (n=74), which aimed to compare sarcopenia risk classification obtained using SARC-F, SARC-CalF, and BMI-adjusted SARC-CalF, as well as to analyze agreement, reclassification, and factors associated with positive reclassification. In the first study, 46.1% of the older adults presented loss of muscle mass, which was associated with physical limitation, vulnerability, and age group ≥85 years (p<0.05). Vulnerability was the main factor associated with loss of muscle mass (R²=8.8%; B=0.781; 95% CI 0.690–0.884; p<0.001). In the second study, BMI adjustment increased the prevalence of low CC according to both the CSPI cut-off points (47.6% to 64.4%) and the Brazilian population cut-off points (74.7% to 89.3%). Overweight was the main determinant of reclassification and gain, whereas age and sex were not consistently associated. Gain models showed good discrimination (AUC 0.813 and 0.834). In the third study, the prevalence of sarcopenia risk increased progressively across the instruments [SARC-F (11.0%), SARC-CalF (37.3%), and BMI-adjusted SARC-CalF (61.2%)], with a significant between-country difference observed only for BMI-adjusted SARC-CalF (Spain 78.4% vs. Brazil 56.1%; p=0.001). BMI adjustment increased the classification of individuals “at risk,” with the greatest incremental impact among Spanish participants aged ≥80 years, among whom positive reclassification between standard and adjusted SARC-CalF was 39.3% (p<0.001). Overweight increased the odds of positive reclassification from standard to BMI-adjusted SARC-CalF (OR 3.36; 95% CI 1.68–6.73), with moderate discrimination (AUC 0.712). These findings reinforce the relevance of CC as a simple and useful measure in the assessment of older adults’ health, but indicate that its interpretation should not be performed in isolation, since adiposity may mask muscle alterations. Taken together, the evidence suggests that BMI-adjusted CC may improve the screening of low muscle mass and sarcopenia risk, especially in populations with a high prevalence of excess weight and among the oldest-old.

COMMITTEE MEMBERS:
Interna - 347027 - EULALIA MARIA CHAVES MAIA
Presidente - 1161810 - GILSON DE VASCONCELOS TORRES
Externa à Instituição - Sheila Cristina Rocha Brischiliari - UNIOESTE
Externa ao Programa - 2374850 - THAIZA TEIXEIRA XAVIER NOBRE - nullExterna à Instituição - THALYTA CRISTINA MANSANO SCHLOSSER - UNICAMP