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Ana Lúcia Silva has a total of 25 co-authors. Here are the top co-authors by number of shared publications:


Latest Publications

  • Open Access

    Associations of Muscle Mass, Strength, and Power with Falls Among Active Community-Dwelling Older Adults

    by Priscila Marconcin, Joana Serpa, José Mira, Ana Lúcia Silva, Estela São Martinho, Vânia Loureiro, Margarida Gomes, Petronela Hăisan, Nuno Casanova, Vanessa Santos

    Background/Objectives: Falls are a leading cause of morbidity and mortality in older adults, even among those who are physically active. This study examined the associations between skeletal muscle mass, muscle strength, and muscle power and fall risk in physically active, community-dwelling older adults. Methods: A cross-sectional analysis was conducted with 280 participants (71.9 ± 5.3 years; 75% women) enrolled in the Stay Up–Falls Prevention Project. Assessments included skeletal muscle mass (anthropometric prediction equation), handgrip strength, lower limb strength and power (Five Times Sit-to-Stand test, 5×STS), and fall history over the past 12 months. Muscle power was calculated from 5×STS performance using the equation proposed by Alcazar and colleagues. Logistic regression models and receiver operating characteristic (ROC) curve analyses were performed. Results: Overall, 26.4% of participants reported at least one fall in the previous year, with a higher prevalence among women (28.9%) than men (18.8%). Fallers showed significantly lower handgrip strength (23.1 vs. 25.4 kg, p = 0.022) and poorer lower limb strength (9.2 vs. 8.7 s, p = 0.007) compared with non-fallers. However, no significant differences were found for skeletal muscle mass or sit-to-stand–derived power. In multivariable models adjusted for age, sex, body mass index, comorbidities, and medications, lower limb strength remained the only independent variable associated with fall status (OR = 1.78, 95% CI: 1.11–2.85, p = 0.016). ROC analysis confirmed fair discriminative capacity for 5×STS performance (AUC = 0.616, p = 0.003), with an optimal cut-off of 8.62 s (sensitivity = 78.4%, specificity = 33.0%). Handgrip strength, muscle mass, and power did not show independent associations with fall status. Conclusions: These findings indicate that the 5×STS test provides a simple, cost-effective, and functional indicator for fall-risk stratification in physically active older adults. Clinicians should consider the 5×STS as a sensitive functional indicator that contributes to fall risk stratification, ideally combined with complementary assessments (e.g., balance, gait, cognition) to improve risk stratification and guide preventive interventions in ageing populations.


  • Open Access

    Muscle Mass, Strength, and Power as Predictors of Falls among Active Community-Dwelling Older Adults

    by Priscila Marconcin, Joana Serpa, José Mira, Ana Lúcia Silva, Estela São Martinho, Vânia Loureiro, Margarida Gomes, Petronela Hăisan, Nuno Casanova, Vanessa Santos

    Background/Objectives: Falls are a leading cause of morbidity and mortality in older adults, even among those who are physically active. This study examined the associations of skeletal muscle mass, muscle strength, and muscle power with fall risk in community-dwelling, physically active older adults. Methods: A cross-sectional analysis was conducted with 280 participants (71.9 ± 5.3 years; 75% women) enrolled in the Stay Up–Falls Prevention Project. Assessments included skeletal muscle mass (anthropometric prediction equation), handgrip strength, lower-limb strength and power (Five Times Sit-to-Stand test, 5xSTS), and fall history over the past 12 months. Muscle power was calculated from 5xSTS performance using the equation proposed by Alcazar and colleagues. Logistic regression models and receiver operating characteristic (ROC) curve analyses were performed. Results: Overall, 26.4% of participants reported at least one fall in the previous year, with a higher prevalence among women (28.9%) than men (18.8%). Fallers showed significantly lower handgrip strength (23.1 vs. 25.4 kg, p = 0.022) and poorer lower-limb strength (9.2 vs. 8.7 s, p = 0.007) compared with non-fallers. However, no significant differences were found for skeletal muscle mass or sit-to-stand–derived power. In multivariable models adjusted for age, sex, body mass index, comorbidities, and medications, lower-limb strength remained the only independent predictor of falls (OR = 1.78, 95% CI: 1.11–2.85, p = 0.016). ROC analysis confirmed fair discriminative capacity for 5xSTS performance (AUC = 0.616, p = 0.003), with an optimal cut-off of 8.62 s (sensitivity = 78.4%, specificity = 33.0%). Handgrip strength, muscle mass, and power did not show independent predictive value. Conclusions: These findings indicate that the 5xSTS test provides a simple, cost-effective, and clinically relevant measure for fall-risk screening in active older adults. Clinicians should consider the 5xSTS as a sensitive first-line screening tool, ideally combined with complementary assessments (e.g., balance, gait, cognition) to improve risk stratification and guide preventive interventions in ageing populations.

  • Open Access

    Comparing International Guidelines for the Remission of Hypertension After Bariatric Surgery

    by Carina Vieira Dias, Ana Lúcia Silva, Joana Dias, Paulo Cardoso, Rute Castanheira, Andreia Fernandes, Filipa Nunes, Tina Sanai, Mercedes Sanchez, João Maia-Teixeira, et al.

    Background/Objectives: Obesity remains a global health concern and is associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease overall. Dissimilar hypertension guidelines are available for clinicians, namely those prepared by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which may lead to distinctive appreciation of health outcomes of patients with obesity after bariatric and metabolic surgery, such as hypertension remission. The main goal of this study was to compare the effects of applying stricter (AHA) versus looser (ESC) blood pressure criteria on hypertension diagnosis pre-bariatric surgery and remission assessment one year post-op. Methods: A retrospective analysis of clinical data from patients who underwent surgical treatment for obesity at a single university hospital was performed. To evaluate the hypertension improvement or remission, two different types of blood pressure (BP) categorization were considered (based on AHA and ESC guidelines), in which each patient would fit according to their BP values pre- (m0) and 12 months postoperative (m12). Results: From a sample of 153 patients submitted for surgical treatment of obesity, more patients were considered with hypertension based on the AHA guideline (130 vs. 102; p < 0.001), while a higher rate of hypertension remission at 12 months after bariatric surgery was observed when following the ESC guideline (58.82 vs. 53.08%). Baseline patients’ clinical characteristics based on each hypertension outcome were mostly independent of the guideline used (p > 0.05), where only age and systolic blood pressure were relatively higher in “ESC groups”. Conclusions: We conclude that only minor differences exist between the two guidelines used. If evaluated based on ESC guidelines, it is expected that less patients are considered with hypertension, and the remission rate may be, at least numerically, higher.


  • Open Access

    Study on the Influence of Physical Activity Intensity and Maturation on Sports Injuries in Children and Adolescents

    by Lara Costa e Silva, Ana Lúcia Silva, Júlia Teles, Isabel Fragoso

    Intensive training combined with a growing body can predispose children to sports injuries. Our aim was to identify the importance of physical activity (PA) intensity and maturity as predictors of injury in youth. Information about injuries was collected using a questionnaire (LESADO), the PA intensity was assessed via accelerometry, and maturity was assessed using the Tanner–Whitehouse III bone age method and maturity offset. A total of 121 participants aged between 10 and 18 years were selected from four different schools. Regression analyses were used to determine the significant predictors of the injury profile. Only the injury type presented significant results. The time spent on moderate PA (χ2(2) = 6.701, p = 0.035) and bone age (χ2(2) = 7.196, p = 0.027) were the final predictors. The odds of having a strain or a fracture relative to a sprain increased 1.04 times for each minute of time spent on moderate PA. Likewise, the odds of having a strain or a fracture relative to a sprain decreased by 1.7 times per year of bone age. The PA intensity and bone age proved to be injury predictors in the growing athletes, with more predictive power in injury type. No meaningful associations were found for the injury occurrence, injury rate and body area injury location.


  • Energy intake and expenditure in children and adolescents, contributions of biological maturity

    by Ana L. Silva, Júlia Teles, Luís F. Olivares, Isabel Fragoso

    Objective: The aim of this study was to examine the relationship between the ratio of energy intake (EI) and energy expenditure (EE) and body composition, physical activity and macronutrients intake, considering maturity as a moderator.Methods: The study involved 459 adolescents aged 10 to 17. Energy and macronutrients intake were estimated using a valid Food Frequency Questionnaire; basal metabolic rate (BMR) was predicted from Schofield equations and EE was estimated using BMR and physical activity level obtained through a Portuguese validated biosocial questionnaire.Body mass index, body composition, and bone age were objectively measured. Statistical analyses included independent samples t‐tests, ANCOVA and Pearson correlations. All analyses were adjusted for chronological age, sex, and EI.Results: Body mass index, fat and fat‐free mass, physical activity and protein intake were negatively correlated with EI/EE (P < .001). The study showed significant interactions between maturity and body mass index, fat‐free mass and physical activity level. Maturity attenuated the negative relationships between EI/EE and body mass index, fat‐free mass and physical activity, especially among early maturers. All categories of maturity showed implications in body mass index for values lower than 23.8 kg/m2. A significant EI/EE reduction was observed among late maturers with a fat‐free mass above 39.8 kg.Conclusions: Our findings suggest that maturity moderates the relationship between EI/EE and body mass index, fat‐free mass and physical activity, especially evident among late maturers.