The study was implemented with 102 participants, aged 60 years or older. These participants included a group of volunteers who resided in the municipality of Viçosa-Minas Gerais, Brazil.
Clinical Data: Volunteers who participated in the study required a recent laboratory examination or they had completed one within the last six months. The examination included the measurement of cholesterol (HDL), glucose, and triglyceride levels.
Abdominal circumference: For all participants, abdominal circumference was measured (this measurement was performed by positioning a tape measurer along a horizontal plane between the lower rib margin and the upper border of the iliac crest).
MetS: Based on the criteria of the NCEP-ATP III group, MetS was defined by the presence of hypertension and two or more of the following criteria:10,13-18
- Abdominal obesity: From NCEP-ATP III the waist circumference is ≥ 102 cm in men and ≥ 88 cm in women. But according to the IDF, the waist measurement parameters for South and Central America are established according to data from South Asia, where waist circumference associated with MetS has values of ≥ 90 cm in men and ≥ 80 cm in women. The criteria from IDF were used in this study.20
- Hypertriglyceridemia: triglycerides ≥ 150mg/dL
- High density lipoprotein cholesterol (HDL): ≤40mg/dL for men and ≤50mg/dL for women.
- Alteration of glucose metabolism: high fasting glycemia ≥100 mg/ dL.
- Blood pressure parameters were defined according to the criteria established by the NCEP-ATP III group, where the value considered as consistent with MetS was ≥ 130/85 mmHg.
Medication analysis: The volunteers had to present their list of medications in current use, the time of consumption, the dosages, and the reason for their use.
Tests for fall risk analysis: Three tests were performed: 1. Timed Up & Go (TUG) test: The (TUG) test was used as a test for functional mobility and fall risk analysis.27The TUG test is a simple test that measures the likelihood that an elderly person will fall.28A standard chair is used, and the participant is invited to stand up, walk a line 3 meters away, and return to the seat. The timer was triggered from the point at which the patient’s buttocks moved from the seat and made contact with the back of chair. The volunteers for whom it took ≥13 seconds to perform the test were identified as having a higher risk of falling.27,28 The chronometer used was a mobile device model X1069 G(Motorola).
2.Gait analysis: Participants performed the Tandem test, which consists of walking in a straight line drawn on the floor and placing the non-dominant foot heel in front of the toes of the dominant foot at each step.29 The scoring for the test was determined according to the following characteristics: The participant who completed 10 steps in the straight line was deemed as having good performance and normal balance. If the participant completed 7-9 steps, he/she was considered to have an average balance deficit, but no risk of falling was assessed. If the participant completed 4-7 steps, they demonstrated a moderate deficit in balance, which lead to some concern about the risk of falling. Finally, the participants who achieved completion of less than 4 steps were considered as having a high level of balance deficit and thus were considered to be at high risk of falling.29,30
3.Functional Reach Test: In the Functional Reach Test, participants standing in the orthostatic position next to a wall marked with a straight tape measure were instructed to perform a trunk flexion movement. During this movement, the extended arm demarcated the limit of its antero-posterior movement, without involving the movement of the legs, which must maintain their alignment from the beginning to the end of the movement. Values ≥ 15 test score indicated that there was a deficit in balance that can lead to a greater risk of falling.30,31
Mean arterial pressure (MAP): The MAP is a term to describe an average blood pressure in an individual. It is defined as the average arterial pressure during a single cardiac cycle. The equation for the MAP is as follows: MAP = 1/3 systolic blood pressure (SBP) + 2/3 diastolic blood pressure (DBP).32
Falls history: The volunteers participating in the study were questioned about the occurrence of falls within a one-year period.
Falls Efficacy Scale-International (FES-I): This is a questionnaire that assesses the individual's concern about suffering falls when performing their daily activities. The FES-I is a questionnaire modified by Chris Todd and Lucy Yardley through the Falls Efficacy Scale (FES), which was developed by Tinetti. It consists of 16 questions focused on activities of daily living and social life, with answers to each item having a score from 1 to 4 (1 = not worried, 2 = worried, 3 = very worried, and 4 = extremely worried). The scoring system ranges from 16 to 64 points. A score of 16-19 points indicates the participant has little concern about falling. Values of 20-27characterize a moderate preoccupation with concern about falling, while values ranging from 28-64 points indicate the participant maintains great concern about suffering a fall.33,34
Quality of Life Questionnaire (the Short Form [SF]-36): This is a questionnaire that measures health status. It calculates the cost-benefit ratio of a health treatment. It consists of eight scales, which are the weighted sums of questions in each section. The lower the score, the greater the degree of disability, and the higher the score, the lesser the degree of disability. A score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability, which is associated with a perceived excellent quality of life.26,35